NTM peritonitis in CAPD patients can lead to significant morbidity and mortality. It is thus vital to have high index of suspicion if CAPD peritonitis patients do not respond to conventional antimicrobial therapy. Accurate early diagnosis and prompt treatment with appropriate antimicrobials may improve patients' outcomes.
Cold agglutinin-mediated autoimmune hemolytic anemia (AIHA) is a rare disorder associated with COVID-19 infection. Here, we present a case of COVID-19 pneumonia with concomitant cold agglutinin syndrome (CAS). On admission, the patient was anemic with reticulocytosis and the direct antiglobulin test showed the presence of anti-complement (C3d) antibodies. Peripheral blood film demonstrated red cell agglutination which was dispersible on blood warming. Chest radiography showed bilateral lower zone ground glass appearance. SARS-CoV-2 was detected in the nasopharyngeal and oropharyngeal swab samples by the RT-PCR method. Additional workup for malignancy, autoimmune disease, and other infections yielded negative results. Systemic corticosteroids and oxygen therapy were administered as she developed hypoxic respiratory failure. In addition, she received packed cell transfusion in view of hemolysis. Following corticosteroid and other supportive therapy, she recovered and was discharged well.
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