{"title":"COVID-19大流行背景下呼吸困难的诊断挑战:一份病例报告","authors":"Zamelina Angela Razafindrasoa, Sonia Marcelle Razafimpihanina, Marie Odette Rasoafaranirina, Fidy Arnauld Martin, Finaritra Princy Parfait Andriamahenina, Diamondra Ombanjanahary Andriarimanga, Jocelyn Robert Rakotomizao, Harison Michel Tiaray, Joëlson Lovaniaina Rakotoson, Rondro Nirina Raharimanana","doi":"10.1186/s43162-023-00192-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Since its discovery, COVID-19 has often been the first diagnosis of dyspnea and asthenia, especially during the pandemic waves. However, it is not always COVID-19. We report a particular case of a late-diagnosed HIV-positive patient in Madagascar.</p><p><strong>Case presentation: </strong>A 21-year-old male patient was admitted to a hospital center in Antananarivo for dyspnea and poor general condition. Physical examination revealed hypoxemia of 85% on room air. His chest X-ray showed bilateral reticular-micronodular opacities. He was suspected and treated for COVID-19. On the 15th day of hospitalization, HIV-1 infection complicated by probable pneumocystis was diagnosed. On the other hand, a multimetastatic testicular cancer was also suspected. The patient died after a few hours of hospitalization in the intensive care unit.</p><p><strong>Conclusion: </strong>This was a case of an HIV-positive patient belatedly diagnosed in the complications stage during the COVID-19 pandemic wave. The investigation of the differential diagnoses remains crucial to avoid serial misdiagnosis and to adjust therapeutic management.</p>","PeriodicalId":22465,"journal":{"name":"The Egyptian Journal of Internal Medicine","volume":"35 1","pages":"9"},"PeriodicalIF":1.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887561/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnostic challenge of dyspnea in the context of the COVID-19 pandemic wave: a case report.\",\"authors\":\"Zamelina Angela Razafindrasoa, Sonia Marcelle Razafimpihanina, Marie Odette Rasoafaranirina, Fidy Arnauld Martin, Finaritra Princy Parfait Andriamahenina, Diamondra Ombanjanahary Andriarimanga, Jocelyn Robert Rakotomizao, Harison Michel Tiaray, Joëlson Lovaniaina Rakotoson, Rondro Nirina Raharimanana\",\"doi\":\"10.1186/s43162-023-00192-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Since its discovery, COVID-19 has often been the first diagnosis of dyspnea and asthenia, especially during the pandemic waves. However, it is not always COVID-19. We report a particular case of a late-diagnosed HIV-positive patient in Madagascar.</p><p><strong>Case presentation: </strong>A 21-year-old male patient was admitted to a hospital center in Antananarivo for dyspnea and poor general condition. Physical examination revealed hypoxemia of 85% on room air. His chest X-ray showed bilateral reticular-micronodular opacities. He was suspected and treated for COVID-19. On the 15th day of hospitalization, HIV-1 infection complicated by probable pneumocystis was diagnosed. On the other hand, a multimetastatic testicular cancer was also suspected. The patient died after a few hours of hospitalization in the intensive care unit.</p><p><strong>Conclusion: </strong>This was a case of an HIV-positive patient belatedly diagnosed in the complications stage during the COVID-19 pandemic wave. The investigation of the differential diagnoses remains crucial to avoid serial misdiagnosis and to adjust therapeutic management.</p>\",\"PeriodicalId\":22465,\"journal\":{\"name\":\"The Egyptian Journal of Internal Medicine\",\"volume\":\"35 1\",\"pages\":\"9\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9887561/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Egyptian Journal of Internal Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s43162-023-00192-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Egyptian Journal of Internal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s43162-023-00192-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Diagnostic challenge of dyspnea in the context of the COVID-19 pandemic wave: a case report.
Background: Since its discovery, COVID-19 has often been the first diagnosis of dyspnea and asthenia, especially during the pandemic waves. However, it is not always COVID-19. We report a particular case of a late-diagnosed HIV-positive patient in Madagascar.
Case presentation: A 21-year-old male patient was admitted to a hospital center in Antananarivo for dyspnea and poor general condition. Physical examination revealed hypoxemia of 85% on room air. His chest X-ray showed bilateral reticular-micronodular opacities. He was suspected and treated for COVID-19. On the 15th day of hospitalization, HIV-1 infection complicated by probable pneumocystis was diagnosed. On the other hand, a multimetastatic testicular cancer was also suspected. The patient died after a few hours of hospitalization in the intensive care unit.
Conclusion: This was a case of an HIV-positive patient belatedly diagnosed in the complications stage during the COVID-19 pandemic wave. The investigation of the differential diagnoses remains crucial to avoid serial misdiagnosis and to adjust therapeutic management.
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