tetano
Editor, Senior Moderator
J Med Cases
. 2025 Jan;16(1):6-10.
doi: 10.14740/jmc5064. Epub 2024 Nov 12. Prolonged SARS-CoV-2 Viremia in an Immunocompromised Patient
Mohammed Abdulrasak[SUP] 1 2 [/SUP], Sohail Hootak[SUP] 1 2 [/SUP]
Affiliations
Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise. During the investigation, which encompassed a wide range of microbiological and immunological tests, the patient was initially thought to have a flare of GPA which she was treated for without appreciable improvement, then for multiple microbiological organisms without appropriate resolution of the patient's symptoms. The differential diagnosis of prolonged SARS-CoV-2 infection was reconsidered in October 2023, and then confirmed by the presence of SARS-CoV-2 viremia through polymerase chain reaction (PCR) testing of the blood. The patient received a prolonged course of antiviral therapy with complete clinical, virological and radiological resolution. Prolonged SARS-CoV-2 infection with viremia in immunocompromised individuals needs to be considered on the differential diagnosis list in such patients presenting with constitutional symptoms, with PCR testing of the blood as a simple and effective way to establish the diagnosis.
Keywords: Immunocompromised patient; PCR; SARS-CoV-2.
. 2025 Jan;16(1):6-10.
doi: 10.14740/jmc5064. Epub 2024 Nov 12. Prolonged SARS-CoV-2 Viremia in an Immunocompromised Patient
Mohammed Abdulrasak[SUP] 1 2 [/SUP], Sohail Hootak[SUP] 1 2 [/SUP]
Affiliations
- PMID: 39759167
- PMCID: PMC11699861
- DOI: 10.14740/jmc5064
Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise. During the investigation, which encompassed a wide range of microbiological and immunological tests, the patient was initially thought to have a flare of GPA which she was treated for without appreciable improvement, then for multiple microbiological organisms without appropriate resolution of the patient's symptoms. The differential diagnosis of prolonged SARS-CoV-2 infection was reconsidered in October 2023, and then confirmed by the presence of SARS-CoV-2 viremia through polymerase chain reaction (PCR) testing of the blood. The patient received a prolonged course of antiviral therapy with complete clinical, virological and radiological resolution. Prolonged SARS-CoV-2 infection with viremia in immunocompromised individuals needs to be considered on the differential diagnosis list in such patients presenting with constitutional symptoms, with PCR testing of the blood as a simple and effective way to establish the diagnosis.
Keywords: Immunocompromised patient; PCR; SARS-CoV-2.