COVID-19 and Medical Error in a Pregnant Woman with Pleural Tuberculosis: A Case Report

Document Type : Case Study

Authors

1 Assistant Professor, Department of Radiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 BSc Student of Laboratory Sciences, Student Research Committee, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

3 PhD Student, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 4 Assistant Professor, Department of Obstetrics and Gynecology, Neonatal and Maternal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Student of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Abstract
Introduction: Recently, the pandemic caused by coronavirus disease 2019 (COVID-19) has become a global concern. In addition, the signs and symptoms of COVID-19 are similar to some other bacterial and viral respiratory infections, such as pleural tuberculosis; therefore, it is very important to make an accurate diagnosis of the disease. In this regard, the present study introduced a young pregnant woman with pleural tuberculosis.
Case Report: A 24-year-old primigravida at 34 weeks of gestation referred to Imam Reza hospital in Mashhad, Khorasan-e-Razavi, Iran, with fever, tachycardia, dyspnea, and decrease in respiratory sounds. Considering the clinical signs and symptoms of the patient, such as fever and respiratory symptoms, the case was admitted to the COVID-19 intensive care unit. According to the negative result of reverse transcription-polymerase chain reaction for COVID-19, unusual features of COVID-19 lung involvement in the patient’s computed tomography (CT) report, and similarity of the clinical symptoms with those of tuberculosis, pleural tuberculosis was diagnosed for this patient. Finally, the improvement of her symptoms was observed with the initiation of tuberculosis treatment for the case.
Conclusion: Paying attention to all differential diagnoses and chest CT scan views is important to avoid the unnecessary hospitalization of patients in the centers and wards for COVID-19.
 

Keywords


  1. References


    1. Akbar H, Kahloon R, Akbar S, Kahloon A. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mimicking as pulmonary tuberculosis in an inmate. Cureus. 2020; 12(6):e8464.
    2. World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, 92. Geneva: World Health Organization; 2020.
    3. Jin X, Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020; 69(6):1002-9.
    4. Liu R, Han H, Liu F, Lv Z, Wu K, Liu Y, et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chimica Acta. 2020; 505:172-5.
    5. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020; 19:200432.
    6. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020; 26:200642.
    7. Zhou S, Wang Y, Zhu T, Xia L. CT features
      of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. Am J Roentgenol. 2020; 214(6):1287-94.
    8. Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients. AJR Am J Roentgenol. 2020; 215(1):87-93.
    9. Meili W, Yongjie Z, Zhuoyu Q, Biao Y, Jun X, Jun W, et al. Pneumonia caused by mycobacterium tuberculosis. Microb Infect. 2020; In Press.

    10. Porcel JM. Tuberculous pleural effusion. Lung. 2009; 187(5):263.

    11. Koegelenberg CF, Bolliger CT, Theron J, Walzl G, Wright CA, Louw M, et al. Direct comparison of the diagnostic yield of ultrasound-assisted Abrams and Tru-Cut needle biopsies for pleural tuberculosis. Thorax. 2010; 65(10):857-62.

    12. Ali JS, Mahshid T, Mohammadreza A. Frequency of abnormal findings of lung imaging in patients with pleural tuberculosis who hospitalized to Rasoul Akram Hospital and Firoozgar Hospital during 2000-2001. Razi J Med Sci. 2005; 12(46):261-6.

    13. Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, et al. Stability issues of RT‐PCR testing of SARS‐CoV‐2 for hospitalized patients clinically diagnosed with COVID‐19. J Med Virol. 2020; 92(7):903-8.