Chegini Venus, Hosseini Reihaneh, Zarei Neda, Chegini Victoria, Aghajani Faezeh, Nakhostin-Ansari Amin, Kasraei Sara
Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Obstetrics and Gynecology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ann Med Surg (Lond). 2021 Sep;69:102770. doi: 10.1016/j.amsu.2021.102770. Epub 2021 Aug 31.
Patients with COVID-19 infection may present a wide range of symptoms that make its diagnosis challenging, especially in patients with underlying conditions.
A 30-year-old postpartum woman presented to the Emergency Department (ED) of Arash Women Hospital with right flank pain. Physical examination revealed tachycardia and decreased sounds in the base of the lung. Chest CT scan demonstrated patchy consolidations in bases of the lungs in favor of COVID-19 infection. The patient underwent pharmacotherapy with Remdesivir, steroid, and interferon beta-1a for eight days and was discharged in a good condition.
This study suggests that involvement of lungs' bases may be associated with gastrointestinal symptoms such as abdominal or flank pain in the COVID-19 patients. It makes the diagnosis difficult in a scenario such as the described patient in our study where there may be other differential diagnoses correlating with the patient's clinical course.
COVID-19 should be in the differential diagnosis of any patient presenting to ED with relevant complaints. Correct and immediate diagnosis is critical for proper treatment and isolation of patients with COVID-19.
新型冠状病毒肺炎(COVID-19)感染患者可能出现多种症状,这使其诊断具有挑战性,尤其是对于有基础疾病的患者。
一名30岁的产后女性因右侧胁腹疼痛就诊于阿拉什妇女医院急诊科。体格检查发现心动过速,肺底部呼吸音减弱。胸部CT扫描显示肺底部有斑片状实变,提示为COVID-19感染。该患者接受了瑞德西韦、类固醇和干扰素β-1a的药物治疗,为期8天,出院时情况良好。
本研究表明,肺底部受累可能与COVID-19患者的胃肠道症状如腹痛或胁腹疼痛有关。在我们研究中所描述的患者这样的情况下,这使得诊断变得困难,因为可能存在与患者临床病程相关的其他鉴别诊断。
对于任何因相关主诉就诊于急诊科的患者,COVID-19都应列入鉴别诊断。正确及时的诊断对于COVID-19患者的恰当治疗和隔离至关重要。