Fever and an abnormal chest X-ray during the COVID-19 pandemic

Abstract

During the COVID-19 pandemic, a 56-year-old man presented at our emergency department with fever and shortness of breath; Diffuse pulmonary nodular vascular spread lesions were found. Detailed history taking showed a four-week history of fever and night sweats. The man had been under treatment for 2 years with Adalimumab, a tumor-necrosis-factor (TNF) inhibitor, for ulcerative colitis. Before start, screening by tuberculin skin test was negative. Cultures en PCR on BAL and urine were positive for mycobacterium tuberculosis also ocular findings were present. The diagnosis of military tuberculosis was made. During the COVID-19 pandemic, a 56-year-old man presented at our emergency department with fever and shortness of breath. Based on his complaints and the presence of diffuse bronchovascular accentuation on chest X-ray, he was triaged as suspicious for COVID-19 pneumonia. As the screening was negative for COVID-19, computed tomography of the thorax was made (Fig.