A 31-Year-Old with Cough and Decreased Breath Sounds

Differential Diagnosis

• COVID-19 infection
• Multifocal unilateral pneumonia
• Lymphomatoid granulomatosis
• Pulmonary alveolar proteinosis

Diagnosis

Patchy peripheral infiltrates are noted at the left lung periphery beginning in the left midlung and extending inferiority to the left base. There are no definite infiltrates on right.

This patient was diagnosed with multifocal unilateral pneumonia which may be bacterial, but could also represent an atypical viral infection such as COVID-19.

Learnings/What to Look for

• The only definitive diagnosis of COVID-19 remains viral testing. As imaging findings have significant overlap with other disease entities, chest x-ray can only serve as a supplement to clinical suspicion

Pearls for Urgent Care Management

• If clinical suspicion is high, recommendations are to forgo imaging and instead obtain viral testing

Acknowledgment: Images and case presented by Experity Teleradiology (www.experityhealth.com/teleradiology).

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