RESUMO
We describe a case of prolonged shedding of live Severe Acute Respiratory Syndrome Coronavirus, 2 in the setting of a mild novel Coronavirus Disease 2019 (COVID-19) infection in a healthy young adult male. The patient did not require hospitalization or any supplemental oxygen. The viral cultures remained positive 15 days from symptom onset. The extended duration of positive viral culture with his concurrent mild symptomatology is at odds with current CDC and DOD isolation policies for positive COVID-19 patients. This case is important as health agencies around the world grapple with how to advise patients and create protocols for isolation precautions after positive COVID-19 results.
Assuntos
COVID-19 , Humanos , Masculino , SARS-CoV-2 , RNA ViralRESUMO
Rosai-Dorfman disease, also known as sinus histiocytosis with massive lymphadenopathy is a rare non-Langerhans' cell histiocytic disease resulting from the proliferation and accumulation of sinus histiocytes within lymph nodes. Extranodal involvement frequently occurs, which increases the morbidity and mortality of the disease. There is no clear consensus with regard to the most effective diagnostic and treatment modalities. This report will focus on the diagnostic imaging, treatment, and outcomes for 3 cases of Rosai-Dorfman disease. Imaging has typically utilized computed tomography (CT)/magnetic resonance imaging to detect extranodal involvement. However, the addition of fluorodeoxyglucose positron emission tomography/CT scans has shown value in identifying lesions unidentified or ambiguous on other modalities. Fluorodeoxyglucose positron emission tomography/CT detected disease involvement in 2 instances either not reported or not felt to be significant on correlative CT imaging. Areas of involvement included the stomach/liver in case 1, and the paranasal sinus in case 3. In addition, previously utilized chemotherapy regimens have not consistently displayed regression of the disease, which lends credence to the pursuit of more successful treatment. Notably, Clofarabine has shown promise in its use against histiocytic disorders. Our study concluded that Clofarabine demonstrates the ability to decrease lesion size and should be considered as an effective chemotherapeutic treatment method.