Identification of Complex Pneumonia during the Outbreak of COVID-19: Bacterial Pneumonia Combined with Acute Eosinophilic Pneumonia in Patients with Maintenance Hemodialysis

Abstract

It is of crucial importance to diagnose patients in a timely and clear manner during the outbreak of COVID-19. Different causes of pneumonia makes it difficult to differentiate COVID-19 from others. Hemodialysis patients are a special group of people in this outbreak. We present a successfully treated case of a patient with maintenance hemodialysis from acute eosinophilic pneumonia for using meropenem when treating bacterial pneumonia, avoiding possible panic and waste of quarantine materials in dialysis centers.

Acute Eosinophilic Pneumonia Associated With COVID-19 Infection

“…This case highlights an unusual association of AEP with a COVID-19 infection and the diagnostic challenges of unusual pneumonia during the pandemic [ 2 ]. To our knowledge, this association between AEP and COVID-19 has been reported only in two other case reports (Table 1 ) [ 3 , 4 ].…”

CT patterns and differential criteria for acute eosinophilic pneumonia and COVID‐19 pneumonia

“…Moreover, it can be idiopathic or secondary to inhalational toxic substances, drugs, or infections 6 . Given the current pandemic situation, diagnosing AEP has become even more challenging, since its clinical picture might resemble that of COVID‐19 pneumonia 7 . As such, laboratory tests and anamnesis are crucial for ensuring a correct differential diagnosis 8–10 .…”

Acute Eosinophilic Pneumonia Associated With SARS-CoV-2 Infection

“…Diagnosis is challenging, especially during the current pandemic situation, since the clinical picture might resemble COVID-19 disease. 2 Diagnosis is based on clinical and laboratory criteria, with a leading role of cytological analysis of BAL fluid, where eosinophils usually represent more than 25% of the cells. Lung biopsy is not usually required, unless an alternative diagnosis needs to be excluded.…”