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Case Report: COVID-19 with Bilateral Adrenal Hemorrhage #MMPMID32682452
Alvarez-Troncoso J; Zapatero Larrauri M; Montero Vega MD; Gil Vallano R; Palmier Pelaez E; Martin Rojas-Marcos P; Martin-Luengo F; Lazaro Del Campo P; Herrero Gil CR; Trigo Esteban E
Am J Trop Med Hyg 2020[Sep]; 103 (3): 1156-1157 PMID32682452show ga
A 70-year-old Dominican Republic man presented with lower back pain for 10 days. Fifteen days before pain onset, he had low-grade fever, chills, and asthenia, and 4 days before admission, he had constipation, malaise, generalized weakness, anorexia, nausea, and vomiting. On admission, the patient was afebrile and hypotensive, with a heart rate of 105 and an oxyhemoglobin saturation on room air of 95%. Hyponatremia, lymphopenia, elevated C-reactive protein, and ferritin were observed in complementary tests. Computed tomography (CT) scan showed findings consistent with COVID-19 bilateral bronchopneumonia, and an increase in size and blurring (loss of the Y shape) of both adrenals indicative of acute bilateral adrenal hemorrhage. The patient tested negative by reverse transcription polymerase chain reaction (RT-PCR) of nasopharyngeal swab, yet positive for IgG and IgM by ELISA, suggesting COVID-19 diagnosis.