Covid 19 or a familiar culprit?

A 45-year-old female presented with the following symptoms - Shortness of breath - Productive cough last 2 weeks - Weight loss - Fever Background history - HIV positive on 2nd line ARVs - Unknown CD4 and viral count - No known covid contacts On examination - Vitals: BP 143/92, HR 123, Sats: 52% on RA and 94% on polymask O2, RR- 38 - General: increased BMI, half-and-half nails, generalized lymphadenopathy - Resp: mild alar flaring, SCR, scattered crackles. - others systems: nothing of note What special investigations would you like to do and what would be your differential diagnoses?

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Compermised patient Xray chest shows bilateral GGOs and cardiomegaly H/o ARV SOB WT LOSS FEVER VENTILATION IS poor My first adv to r/o pulmonary tuberculosis Simultaneously adv COVID19 One small fibrovascular cavity is noted rt lower zone with generalised lymphadenopathy most likely tubercular

Thanx dr Dinesh Gupta
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Radiologicaly, bil diffuse parenchymal reticulonoduler opacities with air bronchogram and GGos are seen. Perihilar fluffy infiltration seen. Enlarged cardiac shadow. Adv ABG CT thorax Echo CD FOB BAL including covid 19 RT PCR. CD 4 count, viral load CBC LDH DDs ARDS PCP Kaposi sarcoma Endobronchial Koch's.

K/C/O .. HIV..ON TREATMENT.. WITH.. B/L ..PNEUMONITIS.. CARDIOMEGALY.. ? ARDS.. ? SARI .. ? COVID-19..

Tnx Dr Ashok Leel sir
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Consider COVID infection since patient is immunocompromised. , and she is in respiratory failure. Xray chest is suggestive of Bilateral Pneumonia, ARDS, Cardiomegaly , and Pulmonary edema. Consistent with COVID Suggest ABG, D DIMER,, ECHO

Admission in covid ward and follow protocols as directed by WHO of GOI from time to time. Nasopharyngeal swab and other tests to conclude Covid Infection or otherwise. Previous history and co morbidities indicates more towards Covid Infection.

Thanks Dr Kute Ankush
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ILD, COPD, EMPYSEMA, Massive Cardiomegaly with B/L plueral effusion, Rule of PTB, ?ARDS WITH PNEUMONITIS NEED FURTHER EVALUATION

Immnunocompromised patient. Unknown CD4 and viral load. Fever and cough Take deep nasal and throat swab for investigation and admitt by following Covid protocal guidelines

THIS IS A 45 YESRS FEMALE PATIENT KNOWN H U V ON ARVIRAL TRESTMENT WITH SYMPTOMS OF COUGH FEVER LOSS OF WRIGHT AND SHOTNESS OF BREATH THSESE SYMPTOM S WOULD BE RELATED TO HER HIV STATUS HAD THEIR NOT HAVE BEEN C VIRUS' PANDEMIC IN VIEW OF C V PANDEMIC IT IS BETTER TO QUARANTINE THE PATIENT GET CONSULTATION OF PJYSICIAN TO DO CT SCAN CHEST AND MAY BE SHE WOULD NOT OTHER MEDICAL SUPORT

B/L Pneumonitis Lt upper zone free Cardiomegaly Right pleural effusion collapse consolidation lower lobe ARDS COVID infection

Bilateral infiltrate bilateral Koch's ards hiv pt immunocompromised chances of tb or malignancy do cbnat hrct expiratory films rt pleural effusion do covid test as case is prevalent

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