Respir Case Rep. 2022; 11(3): 156-159 | DOI: 10.5505/respircase.2022.66587

COVID-19-Associated Diffuse Alveolar Hemorrhage: A Case Report

Gülbahar Darýlmaz Yüce¹, Dorina Esendaðlý¹, Koray Hekimoðlu², Merih Tepeoðlu³, Müþerref Þule Akçay^1
1Department of Chest Diseases, Baþkent University, Ankara, Türkiye
²Department of Radiology, Baþkent University, Ankara, Türkiye
³Department of Medical Pathology, Baskent University, Ankara, Türkiye

Diffuse alveolar hemorrhage is a syndrome characterized by cough, hemoptysis, diffuse pulmonary infiltrates, anemia, and hypoxemic respiratory distress, and lung infections also play a role in its etiology. The restricted use of bronchoscopy in COVID-19 patients due to the risk of infection has led to the poor recognition of diffuse alveolar hemorrhage in COVID-19. We present here the case of a 35-year-old patient with laboratory, radiological and bronchoscopic evidence of diffuse alveolar hemorrhage who was diagnosed with COVID-19 by bronchial lavage. The restrictions on the use of bronchoscopy during the pandemic due to the high risk of infection has led diagnoses of COVID-19 to be mistakenly excluded in immunosuppressive patients with a negative SARS-CoV-2 polymerase chain reaction test, and the under-recognition of conditions such as diffuse alveolar hemorrhage and secondary infection in patients with a positive SARS-CoV-2 PCR.

Keywords: COVID-19, Diffuse alveolar hemorrhage, ground-glass opacities

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COVID-19’a Baðlý Diffüz Alveoler Hemoraji: Olgu Sunumu

Gülbahar Darýlmaz Yüce¹, Dorina Esendaðlý¹, Koray Hekimoðlu², Merih Tepeoðlu³, Müþerref Þule Akçay^1
1Baþkent Üniversitesi Göðüs Hastalýklarý Anabilim Dalý, Ankara
²Baþkent Üniversitesi, Radyoloji Anabilim Dalý, Ankara
³Baþkent Üniversitesi, Týbbi Patoloji Anabilim Dalý, Ankara

Diffüz alveoler hemoraji, öksürük, hemoptizi, yaygýn pulmoner infiltratlar, anemi ve hipoksemik solunum sýkýntýsý ile karakterize bir sendromdur. Etyolojisinde akciðer enfeksiyonlarý da rol oynamaktadýr. Enfeksiyon riski nedeniyle COVID-19 hastalarýnda bronkoskopi kullanýmýnýn kýsýtlanmasý, diffüz alveoler hemorajinin COVID-19’da yeterince tanýnamamasýna neden olmaktadýr. Burada SARS-CoV-2 baðlamýnda laboratuvar, radyolojik ve bronkoskopik olarak diffüz alveoler hemoraji kanýtý olan 35 yaþýndaki hastada SARS-CoV-2 için nasofarengeal sürüntü polymerase chain reaction (PCR) testi negatif saptanmýþ, COVID-19 tanýsý bronþ lavajý ile konulabilmiþtir. Yüksek enfeksiyon riski nedeniyle pandemi döneminde bronkoskopi kullanýmýnýn kýsýtlanmasý, SARS-CoV-2 PCR testi negatif immünsupresif hastalarda COVID-19 tanýsýnýn yanlýþlýkla dýþlanmasýna veya SARS-CoV-2 PCR pozitif hastalarda diffüz alveoler hemoraji ve sekonder enfeksiyon gibi durumlarýn yeterince tanýnamamasýna neden olmaktadýr.

Anahtar Kelimeler: COVID-19, Diffüz alveolar hemoraji, buzlu cam opasiteler

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Image Slices of the Case

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