A case of COVID-19 with the atypical CT finding
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COVID-19 usually demonstrates the specific pattern of chest CT findings (GGO, inverted-halo sign, etc). However, some COVID-19 cases show atypical CT findings. Physicians should make comprehensive judgments.

A 30-year-old man presented with a 2-day history of fatigue, fever, and cough without sputum and respiratory failure. 6 days ago, he had participated the banquet and meeting in Tokyo, in which COVID-19 had been spreading. Laboratory tests showed elevated C-reactive protein without the specific findings about any pathogen. Chest CT revealed only tree-in-bud appearance on the right upper lobe and centrilobular nodules with unclear edge on the left lower lobe without typical ground-glass opacity (GGO) as COVID-19. Diagnosis of COVID-19 was made by RT-PCR from nasopharyngeal swab. He has received supportive care, and the symptoms have improved.

COVID-19 usually demonstrates the specific pattern of chest CT findings, such as GGO, inverted-halo sign, and so on. However, it had been reported that several cases showed only atypical findings or no significant findings in chest CT. Although the role of CT images for COVID-19 is extremely high, it is also important to recognize that some cases show only atypical findings in CT, especially at a diagnosis. Physicians should not decide whether or not to carry out PCR test based on CT findings alone. At this time, they should make comprehensive judgment for this pandemic situation.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3115?af=R
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