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胸腔积液作为新型冠状病毒肺炎感染中的一个独立发现。

Pleural effusion as an isolated finding in COVID-19 infection.

作者信息

Hussein Mousa, Haq Irfan Ul, Hameed Mansoor, Thomas Merlin, Elarabi Anam, Allingawi Mona, Al-Bozom Issam

机构信息

Pulmonary Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

Respir Med Case Rep. 2020 Oct 21;31:101269. doi: 10.1016/j.rmcr.2020.101269. eCollection 2020.

Abstract

Common radiological findings of COVID -19 infection include bilateral ground-glass opacities in lower lobes with a peripheral distribution. Pleural effusion is considered a rare manifestation of COVID -19 infection. We present a 52 years old patient with a three-week history of right-sided pleuritic chest pain, fever, and dyspnea. Laboratory investigations revealed high -reactive protein and ferritin levels and a positive COVID-polymerase chain reaction (PCR) from a nasopharyngeal swab. Chest X-ray and Computed tomography (CT) identified a moderate right-sided pleural effusion, which was exudative with mixed cellularity and high Lactate dehydrogenase (LDH). Histopathology of thoracoscopic pleural biopsy didn't reveal granulomas, malignancy, or any microbiological growth. We postulate that having ruled out any other cause the effusion was likely related to the Covid-19 infection. Our case highlights that COVID-19 can present with isolated pleural effusions, therefore it should be kept as an etiology of effusions especially if other possible causes have been ruled out.

摘要

新型冠状病毒肺炎(COVID-19)感染的常见影像学表现包括双下肺外周分布的磨玻璃影。胸腔积液被认为是COVID-19感染的罕见表现。我们报告一名52岁患者,有右侧胸膜炎性胸痛、发热和呼吸困难3周病史。实验室检查显示高反应蛋白和铁蛋白水平升高,鼻咽拭子的COVID-聚合酶链反应(PCR)呈阳性。胸部X线和计算机断层扫描(CT)发现右侧中等量胸腔积液,为渗出液,细胞成分混合,乳酸脱氢酶(LDH)水平高。胸腔镜胸膜活检的组织病理学检查未发现肉芽肿、恶性肿瘤或任何微生物生长。我们推测,在排除任何其他原因后,该胸腔积液可能与COVID-19感染有关。我们的病例强调,COVID-19可表现为孤立性胸腔积液,因此,尤其是在排除其他可能病因后,应将其作为胸腔积液的病因之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56ab/7588696/a9330140a97e/gr1.jpg

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