TY - JOUR T1 - Metastatic pulmonary dissemination as differential diagnosis of COVID-19 disease JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-237453 VL - 13 IS - 10 SP - e237453 AU - Cristel Perdigón Martinelli AU - Carlos Morell AU - Carolina González AU - Cristina Nova-Lozano Y1 - 2020/10/01 UR - http://casereports.bmj.com/content/13/10/e237453.abstract N2 - 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’ 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’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. ER -