A 95-year-old patient with unexpected coronavirus disease 2019 masked by aspiration pneumonia: a case report.
COVID-19
Elderly
Older
Pneumonia
SARS-CoV-2
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
23 Jun 2020
23 Jun 2020
Historique:
received:
13
04
2020
accepted:
02
06
2020
entrez:
25
6
2020
pubmed:
25
6
2020
medline:
1
7
2020
Statut:
epublish
Résumé
Severe acute respiratory syndrome coronavirus-2 infection has become a pandemic disease (coronavirus disease 2019). The infection has moved from China to the rest of the world and Italy represents one of the most affected countries. Older adults are more susceptible to develop complications with the consequent highest mortality rates. We report a case of a 95-year-old Caucasian woman affected by pneumonia, initially defined as common aspiration pneumonia in a bedridden patient with vascular dementia, which later turned out to be coronavirus disease 2019 pneumonia during the initial spread of severe acute respiratory syndrome coronavirus-2 in our district. Some features of a computed tomography scan of her chest and her clinical history with known dysphagia had led at first to a different diagnosis with a consequent exposure of health professionals to infectious risk in two distinct hospitals. In this case report, we describe the clinical/imaging features of coronavirus disease 2019 pneumonia and the diagnostic process that led to a correct diagnosis in a nonagenarian with multiple comorbidities. This case report highlights both the possible pitfalls in diagnosing coronavirus disease 2019 pneumonia in very old patients with comorbidities and the greater than expected spread of the infection, even in individuals with reduced interpersonal contacts and no defined epidemiological link.
Sections du résumé
BACKGROUND
BACKGROUND
Severe acute respiratory syndrome coronavirus-2 infection has become a pandemic disease (coronavirus disease 2019). The infection has moved from China to the rest of the world and Italy represents one of the most affected countries. Older adults are more susceptible to develop complications with the consequent highest mortality rates.
CASE PRESENTATION
METHODS
We report a case of a 95-year-old Caucasian woman affected by pneumonia, initially defined as common aspiration pneumonia in a bedridden patient with vascular dementia, which later turned out to be coronavirus disease 2019 pneumonia during the initial spread of severe acute respiratory syndrome coronavirus-2 in our district. Some features of a computed tomography scan of her chest and her clinical history with known dysphagia had led at first to a different diagnosis with a consequent exposure of health professionals to infectious risk in two distinct hospitals. In this case report, we describe the clinical/imaging features of coronavirus disease 2019 pneumonia and the diagnostic process that led to a correct diagnosis in a nonagenarian with multiple comorbidities.
CONCLUSIONS
CONCLUSIONS
This case report highlights both the possible pitfalls in diagnosing coronavirus disease 2019 pneumonia in very old patients with comorbidities and the greater than expected spread of the infection, even in individuals with reduced interpersonal contacts and no defined epidemiological link.
Identifiants
pubmed: 32576232
doi: 10.1186/s13256-020-02432-7
pii: 10.1186/s13256-020-02432-7
pmc: PMC7309209
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
82Références
JAMA Cardiol. 2020 Jul 1;5(7):819-824
pubmed: 32219357
Br J Radiol. 2016;89(1060):20150654
pubmed: 26861744
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Radiol Res Pract. 2013;2013:584793
pubmed: 23936651
Science. 2020 May 1;368(6490):489-493
pubmed: 32179701
Lancet. 2020 Mar 21;395(10228):e52
pubmed: 32171074
Ren Fail. 2020 Nov;42(1):393-397
pubmed: 32340507
BMJ. 2020 Mar 23;368:m1165
pubmed: 32205334
J Am Geriatr Soc. 2020 May;68(5):939-940
pubmed: 32162679
J Am Med Dir Assoc. 2020 Jan;21(1):62-67
pubmed: 31791902
AJR Am J Roentgenol. 2020 Jul;215(1):87-93
pubmed: 32174129
Eur J Intern Med. 2014 Apr;25(4):312-9
pubmed: 24360244
Lancet Respir Med. 2020 Apr;8(4):420-422
pubmed: 32085846
Eur J Prev Cardiol. 2020 Apr 14;:
pubmed: 33611416
PLoS One. 2016 Apr 14;11(4):e0153759
pubmed: 27077910
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
Clin Chem Lab Med. 2020 Jun 25;58(7):1131-1134
pubmed: 32119647
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
N Engl J Med. 2019 Feb 14;380(7):651-663
pubmed: 30763196
Eur Respir J. 2008 Feb;31(2):477-8; author reply 478
pubmed: 18238956
Radiology. 2020 Jun;295(3):200463
pubmed: 32077789
JAMA. 2020 Apr 14;323(14):1406-1407
pubmed: 32083643
J Am Med Dir Assoc. 2018 Apr;19(4):342-347
pubmed: 29128438
J Am Geriatr Soc. 2008 Mar;56(3):577-9
pubmed: 18315680
J Am Med Dir Assoc. 2019 Jul;20(7):893-898
pubmed: 30826270
Circulation. 2020 May 19;141(20):1648-1655
pubmed: 32200663
J Infect. 2020 Jun;80(6):e14-e18
pubmed: 32171866
JAMA. 2020 May 12;323(18):1843-1844
pubmed: 32159775
J Am Med Dir Assoc. 2015 Oct 1;16(10):842-7
pubmed: 25952475
N Engl J Med. 2020 Mar 5;382(10):970-971
pubmed: 32003551