Abdelhadi Adel, Kassem Abeer
Department of Critical Care Medicine, Saqr Hospital, MOH, Ras Al-Khaimah, Ras Al-Khaimah, United Arab Emirates.
Department of Pulmonary Medicine, IBHOA Hospital, MOH, Ras Al-Khaimah, Ras Al-Khaimah, United Arab Emirates.
Int Med Case Rep J. 2021 Dec 23;14:853-861. doi: 10.2147/IMCRJ.S342054. eCollection 2021.
A South Asian male patient in his mid-forties presented with symptoms of severe 2019-nCoV (COVID-19) and recent brain infarction. Subsequently, he was found to have evidence of sepsis, underlying undetected diabetes mellitus (DM) and oral candida mucositis, possibly leading to the rare occurrence of direct spread to the lung, manifesting as a necrotizing candida lung abscess. We describe the diagnosis, clinical course, and management of the unique complication in this case that occurred during his admission, hospitalization, and eventual successful discharge from the hospital. This case highlights the importance of early identification and treatment of suspected COVID-19 infection based on clinical and radiological assessments before the confirmation of COVID-19 by real-time polymerase chain reaction (rtPCR) test result, especially in patients with hyperglycemia. It also indicates the complications that can occur due to COVID-19 such as arteriovenous manifestations and the rare occurrence of pulmonary candida lung abscess. Early detection and prompt management by interdisciplinary teams in the emergency room, followed by close monitoring of complications in the intensive care unit (ICU), can lead to successful outcomes in severe/critical COVID-19 infection.
一名45岁左右的南亚男性患者出现了严重的2019新型冠状病毒(COVID-19)症状以及近期脑梗死症状。随后,他被发现有败血症、潜在未被检测出的糖尿病(DM)和口腔念珠菌性黏膜炎的迹象,这可能导致了罕见的直接蔓延至肺部的情况,表现为坏死性念珠菌肺脓肿。我们描述了该病例在其入院、住院期间以及最终成功出院过程中发生的这种独特并发症的诊断、临床过程及处理情况。该病例强调了在通过实时聚合酶链反应(rtPCR)检测结果确认COVID-19之前,基于临床和影像学评估对疑似COVID-19感染进行早期识别和治疗的重要性,尤其是在高血糖患者中。它还表明了COVID-19可能引发的并发症,如动静脉表现以及罕见的肺部念珠菌肺脓肿。急诊室的多学科团队进行早期检测和及时处理,随后在重症监护病房(ICU)密切监测并发症,可使重症/危重症COVID-19感染获得成功治疗结果。