Department of Diagnostic Radiology, Humanitas Clinical and Research Center IRCCS, Via Alessandro Manzoni 56, 20089 Rozzano, Milan, Italy.
Paediatric Clinic, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, 43121, Parma, Italy.
BMC Infect Dis. 2021 Feb 27;21(1):232. doi: 10.1186/s12879-021-05911-4.
Although there are reports of otolaryngological symptoms and manifestations of CoronaVirus Disease 19 (COVID-19), there have been no documented cases of sudden neck swelling with rash in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection described in literature.
We report a case of a sudden neck swelling and rash likely due to late SARS-CoV-2 in a 64-year-old woman. The patient reported COVID-19 symptoms over the previous three weeks. Computed Tomography (CT) revealed a diffuse soft-tissue swelling and edema of subcutaneous tissue, hypodermis, and muscular and deep fascial planes. All the differential diagnoses were ruled out. Both the anamnestic history of the patient's husband who had died of COVID-19 with and the collateral findings of pneumonia and esophageal wall edema suggested the association with COVID-19. This was confirmed by nasopharyngeal swab polymerase chain reaction. The patient was treated with lopinavir/ritonavir, hydroxychloroquine and piperacillin/tazobactam for 7 days. The neck swelling resolved in less than 24 h, while the erythema was still present up to two days later. The patient was discharged after seven days in good clinical condition and with a negative swab.
Sudden neck swelling with rash may be a coincidental presentation, but, in the pandemic context, it is most likely a direct or indirect complication of COVID-19.
尽管有关于冠状病毒病 19（COVID-19）的耳鼻喉症状和表现的报道，但在文献中尚未有关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染患者出现突发性颈部肿胀伴皮疹的记录病例。
我们报告了一例 64 岁女性患者可能因 SARS-CoV-2 感染而出现突发性颈部肿胀和皮疹的病例。患者在过去三周内报告了 COVID-19 症状。计算机断层扫描（CT）显示弥漫性软组织肿胀和皮下组织、真皮和肌肉深部筋膜平面的水肿。所有鉴别诊断均被排除。患者已故的 COVID-19 丈夫的病史以及肺炎和食管壁水肿的旁证提示与 COVID-19 有关。鼻咽拭子聚合酶链反应证实了这一点。患者接受洛匹那韦/利托那韦、羟氯喹和哌拉西林/他唑巴坦治疗 7 天。颈部肿胀在不到 24 小时内消退，而红斑仍持续了两天。患者在临床状况良好且拭子阴性的情况下出院，共住院七天。
突发性颈部肿胀伴皮疹可能是偶然表现，但在大流行背景下，极有可能是 COVID-19 的直接或间接并发症。
