Pneumonia Covid-19 case with clinical symptoms of a full body rash

CASE PRESENTATION

History ➡

• Male, 20 year old. 
• Main complaints : fever and rash.
• Current medical history : patient has fever and rash, diagnosed with upper respiratory viral infection. In 6 days after that the condition did not improve. The patient is then taken to Emergency Unit. 

Physical examination ➡

• Blood pressure : 93/54
• Pulse rate : 115 times/minute
• Breath rate : 24 times/minute
• Temperature : 39,4°C
• O² Saturation : 91%
• Skin : maculopapular rash, extensive morbilliform in almost all parts of the body (except face).

• Other physical examination within normal limits.

Supporting examination ➡

Chest radiograph : bilateral infiltrates (compatible with multifocal pneumonia). 

Laboratory.

Leukocytes : 8300 uL

Normal value : 4200-9100 uL

Lymphocytes : 800 / uL

Normal value : 1300-3600 / uL

CRP : 118.5 mg / L

Normal value : 0-5 mg / L

Rapid Strep Test : -

HIV : -

Treatment.

1. Patients need supplemental oxygen during the emergency room.
2. The patient was moved to the ICU.
3. SARS-CoV-2 PCR test was carried out (on day 2 a positive result was found).

Diagnosis. 

Pneumonia Covid-19. 

Discussion.

• This case shows a young male patient infected with Covid-19 with symptoms of fever and extensive rash.
• The rash that appears matches the exanthem viral description.
• Most cases of Covid-19 manifest clinically with fever, coughing, spasms and congestion.
• Only 2 of the 1099 patients in the Guan Et Al study had symptoms of a rash, but the type of rash was not explained.
• Until now there has been no other publication related to Covid-19 with clinical symptoms in the form of dermatological disorders.
• Rash symptoms are very rare, but can be a concern for health workers when finding patients with similar symptoms.