RESUMO
Background: Since its discovery, COVID-19 has often been the first diagnosis of dyspnea and asthenia, especially during the pandemic waves. However, it is not always COVID-19. We report a particular case of a late-diagnosed HIV-positive patient in Madagascar. Case presentation: A 21-year-old male patient was admitted to a hospital center in Antananarivo for dyspnea and poor general condition. Physical examination revealed hypoxemia of 85% on room air. His chest X-ray showed bilateral reticular-micronodular opacities. He was suspected and treated for COVID-19. On the 15th day of hospitalization, HIV-1 infection complicated by probable pneumocystis was diagnosed. On the other hand, a multimetastatic testicular cancer was also suspected. The patient died after a few hours of hospitalization in the intensive care unit. Conclusion: This was a case of an HIV-positive patient belatedly diagnosed in the complications stage during the COVID-19 pandemic wave. The investigation of the differential diagnoses remains crucial to avoid serial misdiagnosis and to adjust therapeutic management.
RESUMO
Bronchial dilatation is a potentially serious and irreversible clinical and radiological entity. It is an often underdiagnosed condition, particularly in developing countries. This clinical image presents bronchial dilatations of casual discovery associated with radiographic images suggestive of progressive pulmonary tuberculosis. Thoracic imaging remains crucial in the diagnosis of bronchopulmonary diseases.