Published online Apr 6, 2020. doi: 10.12998/wjcc.v8.i7.1265
Peer-review started: February 17, 2020
First decision: March 5, 2020
Revised: March 6, 2020
Accepted: March 27, 2020
Article in press: March 27, 2020
Published online: April 6, 2020
Processing time: 48 Days and 20.7 Hours
The first case of pneumonia subsequently attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, Hubei Province on December 8, 2019. The symptoms included fever, coughing, and breathing difficulties. A few patients with this infection may only have atypical symptoms, which could lead to a misdiagnosis and subsequently further facilitate the spread of the virus.
A 74-year-old female patient complained of severe diarrhea. She did not have fever, coughing, or breathing difficulties. A physical examination revealed no obvious positive signs. The patient had been hypertensive for more than 10 years. Her blood pressure was well controlled. On January 9, 2020, the patient’s son visited a colleague who was later confirmed positive for SARS-CoV-2 and his first close contact with our patient was on January 17. The patient was first diagnosed with gastrointestinal dysfunction. However, considering her indirect contact with a SARS-CoV-2-infected individual, we suggested that an atypical pneumonia virus infection should be ruled out. A computed tomography scan was performed on January 26, and showed ground-glass nodules scattered along the two lungs, suggestive of viral pneumonia. Given the clinical characteristics, epidemiological history, and examination, the patient was diagnosed with coronavirus disease-2019 (COVID-19).
Our patient had atypical symptoms of COVID-19. Careful acquisition of an epidemiological history is necessary to make a correct diagnosis and strategize a treatment plan.
Core tip: Coronavirus disease-2019 (COVID-19) symptoms include fever, coughing, and breathing difficulties. However some patients may only have atypical symptoms, which can lead to a misdiagnosis and further facilitate the spread of the virus. We here report a case of a 74-year-old patient with atypical symptoms, who was later diagnosed with COVID-19.