THEME: "Explore and Emphasize the Innovations of Otorhinolaryngology- ENT"
University of Medicine Abdelmalek Essaadi, Morocco
Title: Sars-Cov-19 associated with aspiration pneumonia in a patient with Parkinson disease: A case report
Time:
Coronaviruses can cause multiple systemic infections respiratory complications are the most recognizable symptoms similar to severe acute respiratory syndrome coronavirus (SARS-CoV). Aspiration pneumonia was the most common reason for the Emergency admission of patients with PD.
Here we
report the case of a patient with Parkinson’s disease admitted for respiratory
insufficiency secondary to Covid-19 and aspiration pneumonia. A 78-year-old
male patient, treated for Parkinson’s disease, was admitted to the emergency
department with symptoms of acute respiratory insufficiency. Four days before
his admission, the patient suffered from solid dysphagia. On physical examination,
the patient was obnibulated, febrile at 39 ?, with clinical signs of
respiratory insufficiency. Computed tomography of the neck and Chest showed
patchy areas of subpleural ground glass opacities with vascular dilatation
associated with bilateral posterobasal and anterior consolidations with air
overlapping imaging characteristics of aspiration and covid 19 pneumonia.
The CT scan
also showed an oesophageal hypodensity consistent with an endoluminal foreign
body. Reverse transcription-polymerase chain reaction (RT-PCR) for COVID-19 was
positive.The diagnosis of Sarscov 19 associated with aspiration pneumonia was
retained. An esophagoscopy was realized, a foreign body visualized in the upper
sphincter of the esophagus and an impacted food bolus was retracted.
We would
like to emphasize the challenging differential diagnosis of pneumonia caused by
aspiration of different materials and Sars-cov 19. Definite discrimination of
the two diagnoses might be impossible. Some radiologic features may suggest one
diagnosis over the other. While lobar or segmental pneumonia, lung abscess, and
empyema have been reported as Complications of aspiration pneumonia these
outcomes are rarely Considered Complications of COVID-19 pneumonia.
Centrilobular nodules and tree-in-bud signs are commonly seen in cases with
aspiration. Interestingly, these CT findings are not frequent in COVID-19
pneumonia and have been categorized as “Atypical” by the Radiological Society
of North America (RSNA), and therefore could be of some Value in proposing a
differential diagnosis. Bilateral subpleural patches of ground-glass opacity
(GGO), especially in basal distribution, have been described as typical for the
diagnosis of COVID-19 pneumonia in suspected Cases. Such a presentation is also
fairly common in aspiration Pneumonia..