Yousaf Zohaib, Siddiqui Mohammed Yaseen Ahmed, Mushtaq Kamran, Feroz Sayeda Efath, Abou Kammar Shady, Mohamedali Mohamed Gaafer Hussein, Chaudhary Haseeb
Medicine, Hamad Medical Corporation, Doha, Qatar.
Gastroenterology and Hepatology, Hamad Medical Corporation, Doha, Qatar.
Case Rep Neurol. 2020 Oct 9;12(3):359-364. doi: 10.1159/000509345. eCollection 2020 Sep-Dec.
COVID-19 has a broad spectrum of clinical presentations, including central nervous system manifestations that are not uncommon. The high pretest probability of COVID-19 in pandemic can lead to anchoring. We present a patient of COVID-19 pneumonia who presented with dyspnea and acute confusional state. His initial workup was suggestive of tuberculous meningoencephalitis with lymphocytic pleocytosis, high protein in CSF analysis, and suspicious MRI findings, which was later confirmed with a positive CSF culture. To the best of our knowledge, it is the first such case. Anchoring to the diagnosis of COVID-19 may deter clinicians from considering other concurrent diagnoses and a poor outcome consequently.
新型冠状病毒肺炎(COVID-19)有广泛的临床表现,包括中枢神经系统表现,这种情况并不罕见。在大流行期间,COVID-19的预检概率很高,可能导致锚定效应。我们报告一例COVID-19肺炎患者,表现为呼吸困难和急性意识模糊状态。他最初的检查提示结核性脑膜脑炎,脑脊液分析显示淋巴细胞增多、蛋白含量高,磁共振成像(MRI)结果可疑,但后来脑脊液培养呈阳性得以确诊。据我们所知,这是首例此类病例。锚定COVID-19的诊断可能会使临床医生不再考虑其他并发诊断,从而导致不良后果。