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New disease
Case report
80-year-old man with dyspnoea and bilateral groundglass infiltrates: an elusive case of COVID-19
Free
  1. Matthew J Samec1,
  2. Ali Khawaja2,
  3. Ashokakumar M Patel2 and
  4. Sagar B Dugani3
  1. 1 Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
  2. 2 Pulmonary Medicine and Critical Care, Mayo Clinic Rochester, Rochester, Minnesota, USA
  3. 3 Hospital Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA
  1. Correspondence to Dr Sagar B Dugani; dugani.chandrasagar{at}mayo.edu

Abstract

COVID-19 is a novel viral infection caused by severe acute respiratory syndrome-coronavirus-2 virus, first identified in Wuhan, China in December 2019. COVID-19 has spread rapidly and is now considered a global pandemic. We present a case of a patient with minimal respiratory symptoms but prominent bilateral groundglass opacities in a ‘crazy paving’ pattern on chest CT imaging and a negative initial infectious workup. However, given persistent dyspnoea and labs suggestive of COVID-19 infection, the patient remained hospitalised for further monitoring. Forty-eight hours after initial testing, the PCR test was repeated and returned positive for COVID-19. This case illustrates the importance of clinical vigilance to retest patients for COVID-19, particularly in the absence of another compelling aetiology. As COVID-19 testing improves to rapidly generate results, selective retesting of patients may uncover additional COVID-19 cases and strengthen measures to minimise the spread of COVID-19.

  • respiratory system
  • pneumonia (respiratory medicine)

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-236069

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    Footnotes

    • Contributors Supervised by SBD. Patient was under the care of MS, AK, AMP and SBD. Report was written by MS, AK, AMP and SBD.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.