Misleading Diagnosis of Radiological Imaging of COVID-19 Pneumonia During Pandemic Era: Risk on the Existence of CMV Infection

Ceva Wicaksono Pitoyo, I Putu Eka Krisnha Wijaya, Vally Wulani, Anindita Kartika Wiraputri, Michael Aaron Romulo

Abstract


Coronavirus disease 2019 (COVID-19) is an acute respiratory disease which rapidly disseminated due to Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) virus. Clinical presentations of COVID-19 are fever, non-productive cough, and dyspnea. Although the diagnosis establishment is done by detecting the viral ribonucleic acid (RNA) through reverse transcription-polymerase chain reaction (RT-PCR) method, CT scan has an important role in detection and treatment of COVID-19 especially in high prevalence regions. Chest CT scan has high sensitivity yet low specificity because there are a lot of other pathological spectrums that also present features of COVID-19 such as ground glass opacities (GGO) and consolidation, one of them is CMV infection. The objective of this case report is to raise vigilance towards other diseases that have radiological image similarities with COVID-19, especially in the immunocompromised patients who are susceptible to viral infections like CMV infection so that the delay in the disease treatment can be prevented.


Keywords


pneumonia; pandemic; CMV infection; respiratory medicine; COVID-19; radiology; internal medicine

References


Carotti M, Salaffi F, Sarzi-Puttini P, et al. Chest CT features of coronavirus disease 2019 (COVID-19) pneumonia: key points for radiologists. Radiol Med [Internet]. 2020;125(7):636-46. Available from: https://link.springer.com/article/10.1007/s11547-020-01237-4 DOI: 10.1007/s11547-020-01237-4.

Böger B, Fachi MM, Vilhena RO, Cobre AF, Tonin FS, Pontarolo R. Systematic review with meta-analysis of the accuracy of diagnostic tests for COVID-19. Am J Infect Control [Internet]. 2020;S0196-6553(20)30693-3. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350782/ DOI:10.1016/j.ajic.2020.07.011.

Tenda ED, Yulianti M, Asaf MM, et al. The importance of chest CT scan in COVID-19. Acta Med Indones. 2020;52(1):68-73.

Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: A Report of 1.014 cases. Radiology [Internet]. 2020;296(2):E32-E40. Available from: https://pubmed.ncbi.nlm.nih.gov/32101510/ DOI: 10.1148/radiol.2020200642.

Parekh M, Donuru A, Balasubramanya R, Kapur S. Review of the chest CT differential diagnosis of ground-glass opacities in the COVID era. Radiology [Internet]. 2020;202504. Available from: https://pubs.rsna.org/doi/10.1148/radiol.2020202504 DOI: 10.1148/radiol.2020202504.

Darden D, Hawkins R, Larson, S, Iovine, N, Prough, D, Efron P. The clinical presentation and immunology of viral pneumonia and implications for management of coronavirus disease 2019. Crit Care Explore [Internet]. 2020;2(4):e01-e09. Available from: https://journals.lww.com/ccejournal/fulltext/2020/ 04000/the_clinical_presentation_and_immunology_of_viral.17.aspx DOI: 10.1097/CCE .0000000000000109.

Dai WC, Zhang HW, Yu J, et al. CT imaging and differential diagnosis of COVID-19. Can Assoc Radiol J [Internet]. 2020;71(2):195-200. Available from: https://pubmed.ncbi.nlm.nih.gov/32129670/ DOI:10.1177/0846537120913033.

Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis [Internet]. 2020;34:101623. Available from: https://pubmed.ncbi.nlm.nih.gov/32179124/ DOI :10.1016/j.tmaid.2020.101623.

Meng X, Deng Y, Dai Z, Meng Z. COVID-19 and anosmia: A review based on up-to-date knowledge. Am J Otolaryngol [Internet]. 2020;41(5):102581. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265845/ DOI:10.1016/j.amjoto.2020.102581.

Cheung KS, Hung IFN, Chan PPY, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: Systematic review and meta-analysis. Gastroenterology [Internet]. 2020;159(1):81-95. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC719 4936/ DOI:10.1053/j.gastro.2020.03.065.

Freeman AM, Leigh, Jr TR. Viral pneumonia. [Updated 2020 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan [cited 2020 Sep 13]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513286/.

Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology [Internet]. 2020;295(3):715-21. Available from: https://pubs.rsna.org/doi/10.1148/radiol.2020200370 DOI: 10.1148/radiol.2020200370.

Rubin GD, Ryerson CJ, Haramati LB, et al. The role of chest imaging in patient management during the COVID-19 pandemic: A multinational consensus statement from the Fleischner Society. Radiology [Internet]. 2020;296(1):172-80. Available from: https://pubs.rsna.org/doi/10.1148/radiol.2020201365 DOI:10.1148/radiol.2020201365.

Nair A, Rodrigues J, Hare S, et al. A British society of thoracic imaging statement: Considerations in designing local imaging diagnostic algorithms for the COVID-19 pandemic. Clinical Radiology [Internet]. 2020;75(5):329-34. Available from: https://www.clinicalradiologyonline .net/article/S0009-9260(20)30096-9/fulltext DOI:10.1016/j.crad.2020.03.008.

Smith, CB. Cytomegalovirus pneumonia. Chest. 1989;95(3):182S–187S. DOI: 10.1378/chest.95.3_supplement.182s.

Moon JH, Kim EA, Lee KS, Kim TS, Jung KJ, Song JH. Cytomegalovirus pneumonia: high-resolution CT findings in ten non-AIDS immunocompromised patients. Korean J Radiol [Internet]. 2000;1(2):73-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2718167/ DOI:10.3348/kjr.2000.1.2.73.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Acta Medica Indonesiana