대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis

A man in 70s with Coronavirus disease (COVID-19)

Radiologic Findings

Figure 1. Initial chest radiography on the day of admission shows subtle opacity in the left lower lung zone.
Figure 2-4 Initial chest CT images show localized peribronchial ground glass opacity (GGO) in the left lower lobe (Figure 2, 4) and mild subpleural interstitial lung abnormality in both lower lung zone (Figure 3)
Figure 5. Follow up portable chest radiography 5 days after admission shows increased extent of the GGO in the left whole lung and the right upper lung zone.
Figure 6-9 Follow up chest CT images 5 days after admission show increased extent of the GGO in left lower lobe and multifocal peribronchial patchy areas of GGO in both lung and small amount of left pleural effusion
Figure 10. Follow up portable chest radiography 10 days after admission shows diffusely increased infiltration in both lung and endotracheal tube insertion state.

Brief Review

Treatment: antibiotics including meropenem, vancomycin and levofloxacin, antiretroviral therapy and peramiflu

A man in 70s was confirmed with COVID-19 infection based on the real-time reverse-transcription-polymerase chain reaction. He didn’t have any history of exposure to patients with COVID-19 infection or trip abroad. The chest radiography and CT on the first day of admission showed localized peribronchial ground glass opacity (GGO) in the left lower lobe. He was treated with antibiotics and antiretroviral therapy but the symptoms worsened and he was transferred to the tertiary hospital. Follow up chest CT scan 5 days after showed bilateral multifocal peribronchial patchy areas of GGO and small amount of left pleural effusion. Despite the treatment, his fever was persistent and desaturation developed. He was moved to intensive care unit and under a mechanical ventilation. Current follow up chest portable radiography shows diffuse infiltration in both lung.