SPLENIC INFARCTION AN ACCOMPANYING PRESENTATION OF SARS-COV-2 PNEUMONIA: CASE REPORT
Dr. Bhushan S. Wankhade*, Dr. Abdelnasser Ahmed Khalaf Alla Ahmed, Dr. Zeyad Faoor Alrais,
Dr. Ammar Mohamed Abdel Hadi, Dr. Adel Elsaid ElKhouly, and Dr. Nowar Nouralla Fadol Elbasier
Coronavirus disease 2019 (COVID-19) is a global pandemic, clinical manifestations range from asymptomatic infection to pneumonia, adult respiratory distress syndrome, sepsis, septic shock, multi-organ failure. Coagulopathy, thromboembolism is common in severe COVID-19 due to complex mechanism. We report the rare case of splenic infarction due to splenic artery occlusion in SARS-CoV-2 pneumonia patient, who presented with left side abdominal pain along with other clinical features of pneumonia. Initially thought was an abdominal manifestation of atypical pneumonia but on detailed evaluation found to be splenic infarction due to thromboembolic complication associated with COVID-19. Splenic infarction latter complicated as splenic abscess, which complicated the overall clinical course of the patient. Splenic infarction in COVID-19 will occur due to thromboembolic occlusion of the splenic artery. Clinical presentation may range from asymptomatic infraction to hemorrhagic shock due to spleen rupture. CECT abdomen is the diagnostic modality of choice. The splenic infarction can complicate as spleen rupture, hemorrhage, splenic abscess, pseudocyst formation. Management involves good hydration, analgesia, anticoagulation, observation for any complication, and intervention required if the patient developed any complication. Prognosis is good with anticoagulation. All physicians managing COVID-19 patients should suspect splenic or other visceral ischemia or infraction if the patient present with abdominal pain. This clinical scenario required prompt investigation and management.
Keywords: COVID-19, Thromboembolic complications, Splenic infractions, Splenic abscess.
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