COVID 19 related cardiac effussion and endocarditis

37yrs/F left leg cellulitis with High grade fever in Septic shock.COVID 19 positive.CXR FINDINGS? Investigations TLC -32000,PCT -10,D-dimer -2000,S.ferritin -654,LDH -400,CRP -120,Urea -200,S.creat -2

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A case of COVID-19 Pneumonia with septic shock and AKI All are poor prognostic factors. Only hope - Patient is 37 years . X- ray findings- A massive cardiomegaly- may be pericardial effusion and myocarditis Mediastinal widening Left side widespread GGO's . Patient needs,to be managed aggressively 1.Non - invasive ventilation 2.Reno - safe - parenteral antibiotics- 3rd generation cephalosporins and meropenam 3.IV fluids - just maintenance on the lower side with inotropic support 4.Maintain CVP line and monitor urine output 5.Inj Dexamethasone 6.LMWH 7 Inj Remdesivir 8 Local dressing of the cellulitis area 9 Nephrologist and cardiologist consultation

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Cardiomegaly Left sided inhomogenous opacities seen. Mediastinal widening Possibly collapse on Left side. Evaluate for pulmonary embolism in association with covid pneumonia.

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Multiple organ failure with septic shock X ray of chest shows a opacity in apical region in Rt. Lungs with wide mediastinum with cardiimegaly with rt. Side pleural effusion Near 4th ribs in Lt side shows nodular opacity with left. Lower pneumonitis Multiple findings in this xray We should have to go for HRCT for any mass & pathological findings

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Left sided opacification Right atelectasis or pleural effusion

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