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Atypical Chest Computed Tomography Finding of Predominant Interstitial Thickening in a Patient with Coronavirus Disease 2019 (COVID-19) Pneumonia.
Lau, Jaclyn Yee Cheun; Khoo, Hau Wei; Hui, Terrence Chi Hong; Kaw, Gregory Jon Leng; Tan, Cher Heng.
  • Lau JYC; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Khoo HW; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Hui TCH; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Kaw GJL; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Tan CH; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
Am J Case Rep ; 21: e926781, 2020 Sep 21.
Article in English | MEDLINE | ID: covidwho-782481
ABSTRACT
BACKGROUND Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, SARS-CoV-2, and is associated with severe respiratory disease. There are extensive publications on the chest computed tomography (CT) findings of COVID-19 pneumonia, with ground-glass opacities (GGO) and mixed GGO and consolidation being the most common findings. Those with interstitial thickening manifesting as reticular opacities typically show superimposed ground-glass opacities, giving a crazy-paving pattern. CASE REPORT We report the case of a 77-year-old man with a background of asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) who presented with progressive cough and shortness of breath for 2 days. He was in close contact with a confirmed COVID-19 case. Reverse-transcription polymerase chain reaction analysis of a nasopharyngeal swab was positive for SARS-CoV-2. The initial chest radiograph was negative for lung consolidation and ground-glass opacities. During admission, he had worsening shortness of breath with desaturation, prompting a chest CT examination, which was performed on day 14 of illness. The chest CT revealed an atypical finding of predominant focal subpleural interstitial thickening in the right lower lobe. He was provided supportive treatment along with steroid and antibiotics. He recovered well and subsequently tested negative for 2 consecutive swabs. He was discharged after 34 days. CONCLUSIONS Interstitial thickening or reticular pattern on CT has been described in COVID-19 pneumonia, but largely in association with ground-glass opacity or consolidation. This case demonstrates an atypical predominance of interstitial thickening on chest CT in COVID-19 pneumonia on day 14 of illness, which is the expected time of greatest severity of the disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Radiographic Image Enhancement / Lung Diseases, Interstitial / Coronavirus Infections / Severe Acute Respiratory Syndrome / Multidetector Computed Tomography Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: Ajcr.926781

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Radiographic Image Enhancement / Lung Diseases, Interstitial / Coronavirus Infections / Severe Acute Respiratory Syndrome / Multidetector Computed Tomography Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: Am J Case Rep Year: 2020 Document Type: Article Affiliation country: Ajcr.926781