Case Report | DOI: https://doi.org/10.31579/2690-4861/034
*Corresponding Author: Li Zhu, MD, Department of Radiology, General Hospital of Ningxia Medical University, 804 Shengli Street, Xingqing District, Yinchuan 750004, Ningxia, China.
Citation: Y Wang, X Tian, T Li, Y Niu, L Zhu et all. (2020) Cecal Volvulus Following Biliopancreatic Diversion with Duodenal Switch: A Case Report. International Journal of Clinical Case Reports and Reviews. 3(2); DOI: 10.31579/2690-4861/034
Copyright: © 2020 Li Zhu, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 14 July 2020 | Accepted: 07 August 2020 | Published: 11 August 2020
Keywords: Keywords
Abstract
List of abbreviations
CT: computed tomography
RT-PCR: reverse transcriptase-polymerase chain reaction
COVID-19: 2019 coronavirus disease
Introduction
Recently, a cluster of cases of pneumonia has outbroken and spread rapidly in Wuhan, China.1-4 Chinese health authority conformed that it was associated with 2019 novel coronavirus.5 This article reports a patient who presented with 2019 novel coronaviral pulmonary infection. The study protocol was approved by the Ethics Committees of the General Hospital of Ningxia Medical University, and the patient provided written informed consent.
Case presentation
A 51-year-old male presented to the hospital with a 4-day history of fever and dry cough due to unknown causes. He disclosed that he traveled to Wuhan, China (the center of novel coronavirus outbreak) from January 12–16, 2020.
The body temperature of the patient was elevated to 38.5 °C. Lung auscultation revealed rhonchi in both lower lungs. Laboratory results showed leucopenia (white blood cell count was 3.26 × 109/L). The white blood cell differential count showed that neutrophils were 62.9% and lymphocytes were 31%. The level of C-reactive protein increased to 30.51 mg/L (normal range, 0-6 mg/L) and erythrocyte sedimentation rate was elevated to 25 mm/h (normal range, 0-20 mm/h). Unenhanced chest computed tomography (CT) showed multiple peripheral ground-glass opacities in both lungs (Figure 1A). Strikingly, the first four times of reverse transcriptase-polymerase chain reaction (RT-PCR) of the patient’s oropharyngeal swab were negative for 2019 coronavirus disease (COVID-19) nucleic acid, while the fifth RT-PCR was finally positive on February 3, 2020.
Based on the epidemiological characteristics, clinical manifestations, CT findings, and laboratory tests, the diagnosis of COVID-19 pneumonia was confirmed. The patient was treated with antiviral medicine (lopinavir/ritonavir) and interferon inhalation. The follow-up CT scans indicated progressive pulmonary opacities (Figure 1B, C).
Discussion
Although RT-PCR is the gold standard, it could not be replaced by chest CT, and different diseases may show similar signs on CT. However, CT plays a major role in the diagnosis of 2019-nCoV pneumonia and rapid assessment of treatment efficacy.6, 7 Thus, it can be used as a robust supplementary tool when the sensitivity of RT-PCR is not sufficient to identify suspected cases and close contacts for isolation at the earliest.
Consent for publication
Informed written consent was obtained from the patient for publication of this case report and accompanying images.Acknowledgment
Not applicable
Funding
This study was supported by the 2020 Ningxia Autonomous Region key research and development plan (2020BEG03006).
Competing interests
The authors of this work have nothing to disclose.
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