A 40-Year-Old Man with Cough and Fever During the COVID-19 Pandemic

Differential Diagnosis

• Adenovirus
• COVID-19
• Influenza
• Multifocal bilateral pneumonia
• Respiratory syncytial virus

 

Diagnosis

• This patient was diagnosed with multifocal bilateral pneumonia, which may be bacterial but could represent atypical viral infection such as COVID-19. Note the bilateral peripheral patchy infiltrates in the right upper lobe and right lung base, as well as the left upper lobe and left lung base.

 

Learnings/Things to Look for

• COVID-19 presents with often subtle findings on chest x-ray
• Findings associated with COVID-19 infection include multifocal rounded infiltrates
• Infiltrates most often are peripheral in distribution

 

Pearls for Urgent Care Management and Considerations for Transfer

• When presenting in the urgent care setting it is important to realize that a negative chest x-ray does not preclude COVID-19 infection

 

Acknowledgment: Image and case provided by Experity Teleradiology (www.experityhealth.com/teleradiology).