Case Report: COVID-19 Presenting as Acute Undifferentiated Febrile Illness-A Tropical World Threat
Case Report: COVID-19 Presenting as Acute Undifferentiated Febrile Illness-A Tropical World Threat
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DOI：
10.4269/ajtmh.20-0440
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发表时间：
2020-07-01
影响因子：
3.3
通讯作者：
Piyaphanee, Watcharapong
中科院分区：
文献类型：
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作者：
Nunthavichitra, Surat;Prapaso, Suttiporn;Piyaphanee, Watcharapong
我们报告一位来自泰缅边境的年轻泰国男子，在没有呼吸道体征或症状的情况下，出现了两天的发烧和肌痛。他报告说，他没有途经新冠肺炎确诊病例地区或与患者有接触过的历史。排除疟疾和登革热这两种泰国急性未分化发热性疾病(AUFI)的常见病原体后，在新冠肺炎暴发期间，根据我所急性未分化发热性疾病(AUFI)的患者分诊方案进行胸部摄影。胸部X光片显示的结果与肺炎相符。鼻咽、咽喉和痰标本经实时逆转录酶-聚合酶链式反应检测呈SARS-CoV-2阳性。这位患者的入院前诊断为新冠肺炎，使适当的处理和隔离成为可能，以防止医院内传播。新冠肺炎早期的发热和非特异性症状和实验室结果可能很难与热带传染病区分开来，特别是在没有呼吸道症状和体征的情况下。这一事实需要在临床调查、管理和感染控制方面保持警惕，特别是在热带资源有限的环境中。
We report a young Thai man from the Thai-Myanmar border suffering from 2 days of fever and myalgia without respiratory tract signs or symptoms. He reported no history of travel through an area with confirmed COVID-19 cases or contact with sick persons. After excluding malaria and dengue, which are common causative agents of acute undifferentiated febrile illness (AUFI) in Thailand, chest radiography was performed according to the patient triage protocol of our institute for AUFI during the COVID-19 outbreak. Chest radiography revealed findings compatible with pneumonia. Nasopharyngeal, throat, and sputum samples tested positive for SARS-CoV-2 by real-time reverse transcriptase-PCR. The preadmission diagnosis of COVID-19 in this patient enabled appropriate management and isolation to prevent nosocomial transmission. Fever and nonspecific symptoms and laboratory results in early COVID-19 may be difficult to distinguish from tropical infectious diseases, especially when respiratory signs and symptoms are absent. This fact necessitates vigilant awareness in clinical investigation, management, and infection control, especially in tropical resource-limited settings.