José Vilar and Friends Case 27 (Update: Solution!)

Hello friends,

I hope you are doing well wherever you are. Here things are not too good but for the moment I am well.

Here is a case just brought from Dr Peset University Hospital in Valencia.

71 year old man who had a syncope and is brought to the Emergency Room. The COVID 19 ARN (RT-PCR) is negative.

What do you think and what would you do?

Click here for the answer

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    Mar 2020
    DISCUSSION 3 Comments

    3 Responses to : José Vilar and Friends Case 27 (Update: Solution!)

    1. ELM says:

      There’s ill-defined bilateral alveolar opacities (more evident in middle lobe and left superior upper lobe). Due to epidemiologic context and despite negative PCR, these findings can be found on SARS-CoV-2 infection (it has been reported anosmia, syncope and other neurological disorders).

      I would manage this case like a COVID-19 pneumonia and would repeat PCR in 2-3 days. CT scan could be performed, but I think it wouldn’t change pacient management.

    2. Rengarajan says:

      Mitral stenosis

    3. Jessica Muscat says:

      Peripheral subpleural infiltrates. Our centre has adopted CT chest imaging to be performed concomitantly if this patient were for eg to be referred for a CT Brain in view of his syncopal episode. If CT findings confirm ground glass change, subpleural sparing, ‘reverse-halo sign’ and no definite alternative diagnosis – isolation and repeat testing for COVID would be recommended.