@article {Perdig{\'o}n Martinellie237453, author = {Cristel Perdig{\'o}n Martinelli and Carlos Morell and Carolina Gonz{\'a}lez and Cristina Nova-Lozano}, title = {Metastatic pulmonary dissemination as differential diagnosis of COVID-19 disease}, volume = {13}, number = {10}, elocation-id = {e237453}, year = {2020}, doi = {10.1136/bcr-2020-237453}, publisher = {BMJ Specialist Journals}, abstract = {A 13-year-old boy presented to hospital with 3-day self-limited fever, followed by dry cough, persistent asthenia and impaired general condition of 2 weeks{\textquoteright} duration. Blood analyses showed a severe inflammatory status and chest X-ray images were consistent with bilateral COVID-19 pneumonia. He developed an acute respiratory failure that required paediatric intensive care admission and non-invasive ventilation. A targeted COVID-19 treatment was initiated with hydroxicloroquine, corticosteroids, enoxaparine and a single dose of tocilizumab. Repeated serological tests and real-time reverse transcription PCR for SARS-CoV-2 were negative. Other infectious pathogens were also ruled out. Thoracic high resolution CT showed an intense bilateral pulmonary dissemination with lytic vertebral bone lesions. After diagnostic investigations, Ewing{\textquoteright}s sarcoma with metastatic pulmonary dissemination was diagnosed. Nowadays, in the context of SARS-CoV-2 community pandemic, we cannot forget that COVID-19 clinical presentation is not specific and other entities can mimic its clinical features.}, URL = {https://casereports.bmj.com/content/13/10/e237453}, eprint = {https://casereports.bmj.com/content/13/10/e237453.full.pdf}, journal = {BMJ Case Reports CP} }