Eladl Sohaib, Ahmed Mohamed F, Badr Hesham, Shehab Sara, Mzezewa Portia N
Department of Accident and Emergency, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, GBR.
Department of Diabetes and Endocrinology, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, GBR.
Cureus. 2025 May 12;17(5):e83950. doi: 10.7759/cureus.83950. eCollection 2025 May.
Post-COVID-19 complications have been widely identified since the pandemic began in 2019. Among these complications are immune-mediated conditions, including vasculitis, Kawasaki-like disease, and IgA vasculitis. Typically, vasculitis presents with classical features such as rash, shortness of breath, joint problems, visual problems, fibrinoid necrosis, and granulomas. Here, we present a rare and complex case of atypical vasculitis, immunological response, or an autoimmune condition, which posed significant diagnostic challenges and required input from a multidisciplinary team (MDT). Our patient was a 46-year-old female who presented to the emergency department on multiple occasions starting in 2021 after contracting COVID-19 for nearly two months. She presented again in 2023 and 2024 with similar episodes. Despite these multiple presentations, until she presented in 2024 with left neck pain, progressive dysphagia, and hemoptysis. The case was further complicated by systemic involvement as she developed small bilateral lower lung lobe peripheral emboli with no evidence of DVT or any other thrombus during her prolonged hospital stay. Biopsies and laboratory investigations were inconclusive, often showing fungal growth (Candida albicans and glabrata) and excluding malignancy. After extensive discussions, the case was deemed to represent atypical vasculitis, an autoimmune condition, or an infection with a . This case highlights that recurrent oropharyngeal and pharyngeal lesions following COVID-19 infection could indicate these possibilities, even in the absence of classical symptoms.
自2019年新冠疫情大流行开始以来，新冠后并发症已被广泛确认。这些并发症包括免疫介导的疾病，如血管炎、川崎病样疾病和IgA血管炎。通常，血管炎表现出典型特征，如皮疹、呼吸急促、关节问题、视力问题、纤维蛋白样坏死和肉芽肿。在此，我们报告一例罕见且复杂的非典型血管炎、免疫反应或自身免疫性疾病病例，该病例带来了重大诊断挑战，需要多学科团队（MDT）的参与。我们的患者是一名46岁女性，自2021年感染新冠近两个月后多次前往急诊科就诊。她在2023年和2024年又出现了类似症状。尽管有这些多次就诊情况，但直到2024年她出现左颈部疼痛、进行性吞咽困难和咯血。由于在长期住院期间她双侧下肺叶周边出现小栓子，且无深静脉血栓形成（DVT）或任何其他血栓的证据，该病例因全身受累而更加复杂。活检和实验室检查结果不明确，常显示真菌生长（白色念珠菌和光滑念珠菌），且排除了恶性肿瘤。经过广泛讨论，该病例被认为代表非典型血管炎、自身免疫性疾病或某种感染。该病例强调，新冠感染后反复出现的口咽和咽部病变可能提示这些可能性，即使没有典型症状。
