Spannella Francesco, Ristori Letizia, Giulietti Federico, Re Serena, Schiavi Paola, Giordano Piero, Sarzani Riccardo
Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.
Department of Clinical and Molecular Sciences, University "Politecnica delle Marche", Ancona, Italy.
J Med Case Rep. 2020 Jun 23;14(1):82. doi: 10.1186/s13256-020-02432-7.
Severe acute respiratory syndrome coronavirus-2 infection has become a pandemic disease (coronavirus disease 2019). The infection has moved from China to the rest of the world and Italy represents one of the most affected countries. Older adults are more susceptible to develop complications with the consequent highest mortality rates.
We report a case of a 95-year-old Caucasian woman affected by pneumonia, initially defined as common aspiration pneumonia in a bedridden patient with vascular dementia, which later turned out to be coronavirus disease 2019 pneumonia during the initial spread of severe acute respiratory syndrome coronavirus-2 in our district. Some features of a computed tomography scan of her chest and her clinical history with known dysphagia had led at first to a different diagnosis with a consequent exposure of health professionals to infectious risk in two distinct hospitals. In this case report, we describe the clinical/imaging features of coronavirus disease 2019 pneumonia and the diagnostic process that led to a correct diagnosis in a nonagenarian with multiple comorbidities.
This case report highlights both the possible pitfalls in diagnosing coronavirus disease 2019 pneumonia in very old patients with comorbidities and the greater than expected spread of the infection, even in individuals with reduced interpersonal contacts and no defined epidemiological link.
严重急性呼吸综合征冠状病毒2感染已成为一种大流行病（2019冠状病毒病）。该感染已从中国蔓延至世界其他地区，意大利是受影响最严重的国家之一。老年人更容易出现并发症，死亡率也最高。
我们报告一例95岁白种女性肺炎病例，该患者最初被诊断为患有血管性痴呆的卧床患者的普通吸入性肺炎，但在严重急性呼吸综合征冠状病毒2在我们地区最初传播期间，后来被证实为2019冠状病毒病肺炎。她胸部计算机断层扫描的一些特征以及已知吞咽困难的临床病史最初导致了不同的诊断，结果使医护人员在两家不同的医院面临感染风险。在本病例报告中，我们描述了2019冠状病毒病肺炎的临床/影像学特征以及在一名患有多种合并症的九旬老人中做出正确诊断的诊断过程。
本病例报告强调了在诊断患有合并症的老年患者的2019冠状病毒病肺炎时可能存在的陷阱，以及该感染出人意料的广泛传播，即使是在人际接触减少且无明确流行病学关联的个体中。
