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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682On-line version ISSN 1678-9849

Rev. Soc. Bras. Med. Trop. vol.53  Uberaba  2020  Epub Apr 03, 2020

http://dx.doi.org/10.1590/0037-8682-0134-2020 

Images in Infectious Diseases

Chest radiography and computed tomography findings from a Brazilian patient with COVID-19 pneumonia

Bruno Lima Moreira1 

Marcos Pama D’Almeida Brotto1  2 

Edson Marchiori3 
http://orcid.org/0000-0001-8797-7380

1BP - A Beneficência Portuguesa de São Paulo, Medicina Diagnóstica, São Paulo, SP, Brasil.

2Hospital Santa Catarina, Centro de Diagnóstico por Imagem, São Paulo, SP, Brasil.

3Universidade Federal do Rio de Janeiro, Departamento de Radiologia, Petrópolis, RJ, Brasil.

A 73-year-old man was admitted to the emergency department with a 4-day history of fever, chills, dry cough, and fatigue. He had arrived in São Paulo, Brazil, on the preceding day. His symptoms had begun when he was traveling in northern Italy with 12 friends, three of whom had been diagnosed with COVID-19. He reported having systemic arterial hypertension and type 2 diabetes mellitus. On examination, he had a temperature of 37.7°C, heart rate of 85 beats/min, respiratory rate of 15 breaths/min, blood pressure of 112/70 mmHg, and 94% oxygen saturation. His lungs were clear to auscultation. A leukogram was normal, and the patient’s C-reactive protein level was 4.78 mg/dL (normal levels below 1.0 mg/dL).

Chest radiography showed ill-defined lung opacities, notably in the periphery of the left lung. Chest computed tomography (CT) revealed predominantly peripheral ground glass-opacities involving all pulmonary lobes, which were more exuberant in the left lung, where small foci of consolidation were also seen (Figure 1). Real-time reverse-transcription polymerase chain reaction testing of a nasopharyngeal swab confirmed COVID-19 infection.

FIGURE 1: (A) A posteroanterior chest radiograph demonstrating ill-defined lung opacities, notably in the left lung. Chest CT images (lung window) in the coronal (B) and axial (C) planes show predominantly peripheral ground glass-opacities involving all pulmonary lobes, which are more exuberant in the left lung, where small foci of consolidation are also visible. 

In December 2019, a novel viral pneumonia (subsequently named COVID-19 pneumonia) emerged in Wuhan, China1-3. It has spread worldwide, with an increasing number of deaths1-2. The main CT findings of COVID-19 pneumonia include predominantly peripheral ground-glass opacities, the crazy-paving pattern, and/or consolidation of the middle and lower lung regions, usually with bilateral and multilobar involvement1-3. Nonetheless, normal chest CT findings do not exclude this diagnosis1.

REFERENCES

1. Kanne JP. Chest CT findings in 2019 novel coronavirus (2019-nCoV) infections from Wuhan, China: key points for the radiologist. Radiology. 2020; Feb 4:200241. doi: 10.1148/radiol.2020200241. [ Links ]

2. Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. AJR Am J Roentgenol. 2020; Mar 5:1-8. doi: 10.2214/AJR.20.22975. [ Links ]

3. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology. 2020; Feb 13:200370. doi: 10.1148/radiol.2020200370. [ Links ]

Received: March 16, 2020; Accepted: March 27, 2020

Corresponding author: Edson Marchiori. e-mail:edmarchiori@gmail.com

Authors’ contribution: All authors contributed significantly to the work, and have read the manuscript and approved its submission. BLM, MP D’Almeida B and EM took part in conception of the manuscript and data acquisition. BLM and MP D’Almeida B contributed to the analysis and interpretation of data. EM drafted the manuscript and reviewed the literature. All authors gave final approval of the version to be published.

Conflict of Interest: The authors declare that there is no conflict of interest.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License