Case presentation:
A woman her 50s, 5 days before admission, she returned from Europe after 2 weeks abroad. She developed symptoms 2 days later, malaise and fever, 1 day before admission shortness of breath and tight chest. Previously healthy.
Physical exam:
On arrival vital signs were BP 110/70, RR 20, P 98, SPO2 97 % on room air, T 37 °C. She was polypneic. On auscultation crackles in right lower lobe. Rest not contributory.
Pertinent laboratory values:
4800/µL leucocytes, 576/µL Lymphocytes, arterial blood gas revealed pH of 7.40, PCO2 36.8, PO2 86, SpO2 97, normal electrolytes, normal LDH, normal LFTs, negative flu IFI test, FilmArray Pneumonia panel negative.
Pertinent imaging
Chest radiograph demonstrate right lower lobe opacity. CT scan segmental right lower lobe consolidation.
Treatment and Outcomes
She was admitted because of her epidemiological risk factor, started antibiotic with Ceftriaxone and Azithromycin. A day after admission COVID-19 was confirmed by positive RT-PCR. The patient is doing well.
Lesson learned
This case illustrates travel related transmission risk. We should ask ourselves if a COVID-19 patient with mild pneumonia should be treated as an outpatient or as in this case admitted.