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A Case of COVID-19 Pneumonia without Respiratory Symptoms, Referred for “suspected pyogenic spondylitis”
1)Department of Respiratory Medicine, Showa General Hospital, 2)Department of Infectious Control, Showa General Hospital, Japan
Hidenori TAKAHASHI1), Yoshinobu IWASAKI1), Takayuki YOKOZAWA2), Naoki ICHINOSE2) & Toshimi ODA2)
(Received March 2, 2020)
(Accepted May 21, 2020)
Key words: COVID-19, SARS-CoV-2, lumbago

The current criteria for COVID-19 diagnosis include a history of close contact with a known patient and clinical manifestations such as fever and respiratory symptoms. However, we do not believe that all patients with COVID-19 would meet the abovementioned criteria. Herein, we describe a case of COVID-19 in which the patient did not meet the above diagnostic criteria. The patient was a man in his thirties, who presented with a history of persistent back pain and fever (38°C). He was referred to us for suspected pyogenic spondylitis. Chest X-ray and computed tomography revealed multifocal reticular shadows in both lungs, compatible with COVID-19 pneumonia. He had no history of close contact with a COVID-19 patient or any respiratory symptoms, but a polymerase chain reaction (PCR) test yielded positive results for SARS-CoV-2. We suggest that all patients should be medically evaluated on admission to exclude COVID-19 pneumonia, to avoid the risk of misdiagnosis that could result in further transmission of infection, even in the absence of a history of close contact with COVID-19 patients or respiratory symptoms.

[ Kansenshogaku Zasshi 94: 608-612, 2020 ]

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