General Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India.
Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
BMJ Case Rep. 2021 Jan 15;14(1):e240932. doi: 10.1136/bcr-2020-240932.
A 53-year-old man with diabetes came to the emergency department with fever and dry cough for 5 days, swelling of the left leg for 2 days, shortness of breath and chest pain for 1 hour. He had raised temperature, tachycardia, tachypnoea, reduced oxygen saturation and swollen tender left leg on examination. The frontal chest radiograph showed bilateral ground-glass opacities; he tested positive for COVID-19 with elevated D-dimer. The colour Doppler examination of the left leg revealed acute deep vein thrombosis (DVT) of the common femoral and the popliteal veins. The chest CT showed bilateral diffuse ground-glass opacities predominantly involving peripheral zones and the lower lobes. The CTPA revealed left pulmonary thromboembolism (PTE), treated with low-molecular-weight heparin. COVID-19 predominantly affects the respiratory system. DVT and PTE are common in COVID-19 but lethal. They should be diagnosed early by clinical and radiological examinations and treated promptly with anticoagulants.
一位 53 岁的糖尿病男性患者因发热、干咳 5 天，左下肢肿胀 2 天，呼吸困难和胸痛 1 小时到急诊就诊。检查发现患者体温升高、心动过速、呼吸急促、血氧饱和度降低，左下肢肿胀触痛。正位胸部 X 线片显示双侧磨玻璃影；COVID-19 检测呈阳性，D-二聚体升高。左下肢彩色多普勒超声检查显示股总静脉和腘静脉急性深部静脉血栓形成（DVT）。胸部 CT 显示双侧弥漫性磨玻璃影，主要累及周边区和下叶。CT 肺动脉造影显示左肺血栓栓塞症（PTE），给予低分子肝素抗凝治疗。COVID-19 主要影响呼吸系统。DVT 和 PTE 在 COVID-19 中很常见，但具有致命性。它们应通过临床和影像学检查早期诊断，并及时使用抗凝剂进行治疗。
