Thompson Owen, Pierce Damon, Whang Dennis, O'Malley Meaghan, Geise Bob, Malhotra Uma
Department of Medicine, Virginia Mason Medical Center, Seattle, Wash.
Department of Vascular Surgery, Virginia Mason Medical Center, Seattle, Wash.
J Vasc Surg Cases Innov Tech. 2020 Dec;6(4):511-513. doi: 10.1016/j.jvscit.2020.07.017. Epub 2020 Aug 21.
We present the case of a patient with acute upper limb ischemia as the sole initial manifestation of severe acute respiratory syndrome associated with coronavirus disease 2 infection, without concomitant respiratory symptoms or pneumonia. Viral infection presumably precipitated the patient's thromboembolic event, causing multifocal vascular occlusions. This case illustrates that coronavirus disease-19 must be considered in the differential diagnosis of patients presenting with signs or symptoms of coagulopathy, even in the absence of respiratory symptoms. We believe that an awareness of the variety of clinical presentations in patients with coronavirus disease-19, particularly extrapulmonary manifestations, is critical for optimal patient management as well as implementation of appropriate infection prevention measures.
我们报告了一例患者，其急性上肢缺血是新型冠状病毒2型感染所致严重急性呼吸综合征的唯一初始表现，且无伴随的呼吸道症状或肺炎。病毒感染可能引发了患者的血栓栓塞事件，导致多灶性血管闭塞。该病例表明，即使没有呼吸道症状，对于出现凝血功能障碍体征或症状的患者进行鉴别诊断时也必须考虑新型冠状病毒肺炎。我们认为，了解新型冠状病毒肺炎患者的各种临床表现，尤其是肺外表现，对于优化患者管理以及实施适当的感染预防措施至关重要。
