Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2020; 8(8): 1554-1560
Published online Apr 26, 2020. doi: 10.12998/wjcc.v8.i8.1554
Pulmonary contusion mimicking COVID-19: A case report
Li-Ru Chen, Zheng-Xin Chen, Yang-Chun Liu, Lei Peng, Ye Zhang, Quan Xu, Qing Lin, Yun-Ming Tao, Hao Wu, Sui Yin, Ye-Ji Hu
Li-Ru Chen, Yang-Chun Liu, Lei Peng, Ye Zhang, Quan Xu, Qing Lin, Yun-Ming Tao, Hao Wu, Sui Yin, Ye-Ji Hu, Department of Thoracic Surgery, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
Zheng-Xin Chen, Department of Surgery, Yongxin County People's Hospital, Ji’an 343400, Jiangxi Province, China
Author contributions: Chen LR and Chen ZX prepared the case and contributed to manuscript drafting; Chen LR analyzed the case; Liu YC reviewed the literature and contributed to manuscript drafting and study supervision; Peng L, Zhang Y, Xu Q, Lin Q, Tao YM, Wu H, Yin S, and Hu YJ reviewed the literature and drafted the manuscript; all authors gave final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declared no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yang-Chun Liu, MD, Chief Doctor, Department of Thoracic Surgery, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, No. 92, Aiguo Road, Nanchang 330006, Jiangxi Province, China. lyc195411@sina.com
Received: March 5, 2020
Peer-review started: March 5, 2020
First decision: April 1, 2020
Revised: April 8, 2020
Accepted: April 11, 2020
Article in press: April 11, 2020
Published online: April 26, 2020
Processing time: 50 Days and 1.7 Hours
Abstract
BACKGROUND

Coronavirus disease 2019 (COVID-19) is a major public health emergency with obvious characteristics of human-to-human transmission, and there are infective asymptomatic carriers. Early identification and proper management of patients with COVID-19 are important. Features in chest computed tomography (CT) can facilitate identifying newly infected individuals. However, CT findings of some lung contusions are similar to those of COVID-19, as shown in the present case.

CASE SUMMARY

A 46-year-old woman was admitted to hospital for backache and foot pain caused by a fall injury 1 d before hospitalization. She was suspected of having COVID-19, since there was a confirmed COVID-19 case near her residence. But she had no fever, cough, chest tightness, difficult breathing, nausea, vomiting, or diarrhea, etc. On physical examination, the lower posterior chest of both sides showed dullness on percussion and moist rales at the end of inspiration on auscultation. The white blood cell count and lymphocyte count were 10.88 × 109/L and 1.04 × 109/L, respectively. CT performed on February 7, 2020 revealed that both lungs were scattered with patchy ground-glass opacity. The patient was diagnosed with pulmonary contusion with thoracic spinal fracture (T12), calcaneal fracture, and pelvic fracture. On day 9 after conservative treatment, her condition was alleviated. On review of the chest CT, the previous shadows were significantly reduced.

CONCLUSION

Differential diagnosis of lung contusion and COVID-19 must be emphasized. Both conditions require effective prompt actions, especially COVID-19.

Keywords: COVID-19; Pulmonary contusion; Computed tomography; Differential diagnosis; Case report; Ground-glass opacity

Core tip: A 46-year-old female trauma patient had pulmonary contusion that showed similar computed tomography findings to coronavirus disease 2019 (COVID-19) 1 d after injury. Her epidemiological history highly suggested COVID-19. However, the patient was not tested for COVID-19, and the imaging features improved after conservative treatment. This report suggests that in view of the risk of COVID-19, all trauma patients should undergo epidemiological investigations and chest computed tomography examinations, and strict and standardized processing procedures are needed.