Shah Dania A, James Sheridan, Uche Ijeoma U, Sharer Rustan, Radhakrishnan Priya
Internal Medicine, HonorHealth, Scottsdale, USA.
Internal Medicine & Academic Affairs, HonorHealth, Scottsdale , USA.
Cureus. 2021 May 16;13(5):e15060. doi: 10.7759/cureus.15060.
COVID-19 viral pandemic continues to manifest itself in the form of various clinical symptoms. Due to concerns of COVID-19 in the setting of high rates of false-negative, there is increased likelihood of anchoring bias. We present a case of a 48-year-old white female who presented with two weeks of dry cough and diffuse pruritic nodular cutaneous rash. Patient was exposed to a colleague who tested positive for COVID 19. Initial visits were conducted virtually and workup was negative for COVID-19. Patient was offered supportive care; however, her symptoms continued to worsen. Subsequent workup was positive for left lower lobe nodular opacity on the chest X-ray, follow up CT chest showed demonstrated a focal 3.4 cm infiltrate in the left lower lobe pleural base posteriorly, blood workup was positive for eosinophil count, elevated liver enzymes and positive coccidioides antibody IgG and IgM. This case highlights the importance of avoiding anchoring bias when creating differential diagnoses and triaging patients.
新冠病毒大流行仍以各种临床症状的形式表现出来。由于在新冠病毒检测假阴性率较高的情况下对其存在担忧，出现锚定偏差的可能性增加。我们报告一例48岁白人女性病例，该患者出现了两周的干咳和弥漫性瘙痒性结节性皮疹。患者接触过一名新冠病毒检测呈阳性的同事。最初的就诊是通过虚拟方式进行的，新冠病毒检测结果为阴性。患者接受了支持性治疗；然而，她的症状持续恶化。随后的检查显示胸部X光片左肺下叶有结节状模糊影，后续胸部CT显示左肺下叶胸膜基底后部有一个3.4厘米的局灶性浸润，血液检查显示嗜酸性粒细胞计数升高、肝酶升高以及球孢子菌抗体IgG和IgM呈阳性。该病例凸显了在进行鉴别诊断和对患者进行分诊时避免锚定偏差的重要性。
