Open Forum Infect Dis . A Coronavirus Disease 2019 (COVID-19) Mystery: Persistent Fevers and Leukocytosis in a Patient With Severe COVID-19

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Open Forum Infect Dis


. 2020 Dec 18;7(12):ofaa558.
doi: 10.1093/ofid/ofaa558. eCollection 2020 Dec.
A Coronavirus Disease 2019 (COVID-19) Mystery: Persistent Fevers and Leukocytosis in a Patient With Severe COVID-19


Arielle Sasson ¹ , Amna Aijaz ² , Svetlana Chernyavsky ² , Nadim Salomon ³



Affiliations

• PMID: 33365357
• PMCID: PMC7747365
• DOI: 10.1093/ofid/ofaa558

Free PMC article

Abstract

Short-course glucocorticosteroids are being used and tocilizumab (TCZ) had been used to treat patients with severe coronavirus disease 2019 (COVID-19) disease. These agents, when administered individually, have been associated with tuberculosis (TB) during chronic use. We report a case of TB in a 44-year-old male with diabetes and severe COVID-19 who received high-dose short-course glucocorticosteroids and a single dose of TCZ. The clinical presentation was atypical with unresolving fevers and leukocytosis, progressive lower lobe cavities, and hilar adenopathy. Delayed diagnosis led to prolonged hospitalization and extensive antibiotic use.

Keywords: COVID-19; SARS CoV-2; cavitary TB; respiratory infections; tuberculosis.