key: cord-1001247-w08qflq4
authors: Khalili, Mitra; Baeis, Mehdi Gholamzadeh; Saneifard, Hedyeh; Ghanaie, Roxana M.; Shamsian, Bibi Shahin
title: Pediatric with Gaucher Disease and Covid-19: Case Report of Uncommon Manifestation of Covid-19 in Chest Ct
date: 2021-01-18
journal: Vis J Emerg Med
DOI: 10.1016/j.visj.2021.100966
sha: b6a5e91c8e57e71567dd47e5577ae223b66e1df3
doc_id: 1001247
cord_uid: w08qflq4

nan

The use of non-invasive diagnostic tools, fast and available with acceptable safety along with Rt-PCR is very important for better and faster management of COVID-19 patients. One of these diagnostic tools is the use of Non-enhancing Chest CT-scan (1).

The hallmarks of COVID-19 infection on imaging is bilateral and peripheral ground-glass and consolidative pulmonary opacities (2) . Moreover, opacities with a rounded morphology, reticulation, peripheral location of the opacities, consolidation with ground-glass opacities, and crazy-paving pattern had been reported (2).

This is a rare case presentation of lysosomal storage disorder (Gaucher Disease-type 1) and

sever Congenital Neutropenia (HAX1 mutaion -Kostmann Syndrome). Our patient is a rare 

After the outbreak of COVID-19, it was determined that the disease has a series of specific symptoms. In this study, Cavitation in Chest CT-scan as atypical and rare manifestation in a patient who infected with COVId-19 was detected. Therefore, it is recommended that clinicians consider atypical evidence of patients with COVID-19 who have metabolic and immunodeficiency diseases. Due to the history of contact with the infected person with COVID-19 and the suspicion to lower respiratory tract involvement, CBC, ESR, CRP, CXR and Covid-19 RT-PCR tests were requested for the patient. The results of laboratory data were as below:

WBC=5.500 10 3 /µL (Lymph: 77%, Neut: 15%), CRP=+++ ESR=107mm/hr CXR showed Right lobar consolidation, Also due to delay in preparing the Covid-19 RT-PCR test, Chest CT was requested for better evaluation and better therapeutic decision. Chest CT findings included: Lobar consolidation in RUL with Central Cavitation change (Figure 1 and 2) .

Imaging findings were atypical for COVID-19 (2), and bacterial pneumonia was included in the first differential diagnosis, Therefore, blood cultures were requested for the patient and empirical antibiotic therapy with ceftriaxone and vancomycin and also Granulocyte colony-stimulating factor (GCSF) was also administrated. .

After about 48 hours, the result of PCR assay was positive for COVID-19, and also the blood culture test was negative, so Covid-19 treatment was started for the patient [hydroxychloroquine and azithromycin] (6). Patient was discharged after seven days from admission with resolution of clinical symptoms. One month after discharge, she was great clinically and CXR follow up showed complete resolution of the lesion (figure 3).

We thank all the staff of Mofid Children's Hospital. 

Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases

Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection

Gaucher disease and SARS-CoV-2 infection: Emerging management challenges

An Algorithmic Approach to Diagnosis and Treatment of Coronavirus Disease 2019 (COVID-19) in Children: Iranian Expert's Consensus Statement

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.We confirm  that  the  manuscript  has  been  read  and  approved  by  all  named  authors  and  that  there  are  no  other  persons  who  satisfied  the  criteria  for  authorship  but  are  not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing we confirm that we have followed the regulations of our institutions concerning intellectual property.