ABSTRACT
BACKGROUND: In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients. PATIENTS AND METHODS: Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain. RESULTS: Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution. CONCLUSION: International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy
INTRODUCCIÓN: En el contexto de la pandemia por COVID-19 el riesgo de errores en el diagnóstico de otras causas de infección respiratoria es elevado. En este trabajo describimos las características clínicas, el tratamiento y la evolución de los pacientes con coinfección por COVID-19 y neumococo. PACIENTES Y MÉTODOS: Todos los pacientes con COVID-19 que presentaron neumonía neumocócica durante marzo 2020 en un hospital universitario de Barcelona, España. RESULTADOS: Cinco pacientes con COVID-19 confirmada por PCR o sospecha radiológica fueron diagnosticados de infección por neumococo. En todos los casos la radiografía de tórax era patológica con infiltrado unilateral o bilateral. La procalcitonina demostró no ser suficientemente sensible para detectar la infección neumocócica. La antibioterapia fue iniciada de manera precoz en los 5 casos con evolución satisfactoria. CONCLUSIONES: Las guías internacionales no incluyen el cribado universal para coinfección bacteriana. El patrón radiológico del COVID-19 puede ser indistinguible de la neumonía neumocócica, y la frecuencia de la coinfección no ha sido establecida. Los clínicos deben de ser conscientes de la posible asociación de SARS-CoV-2 y neumococo para evitar errores diagnósticos y retrasos en el tratamiento antibiótico
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Superinfection/complications , Pneumococcal Infections/pathology , Coronavirus Infections/diagnosis , Betacoronavirus , Pneumonia, Viral/diagnosis , Pneumococcal Infections/drug therapy , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Polymerase Chain Reaction , Anti-Bacterial Agents/administration & dosage , Radiography, ThoracicABSTRACT
BACKGROUND: In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients. PATIENTS AND METHODS: Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain. RESULTS: Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution. CONCLUSION: International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.
Subject(s)
COVID-19/complications , Coinfection/complications , Pneumonia, Pneumococcal/complications , SARS-CoV-2 , Superinfection/complications , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Biomarkers/blood , Coinfection/diagnosis , Female , Humans , Male , Pneumonia, Pneumococcal/diagnostic imaging , Pneumonia, Pneumococcal/drug therapy , Procalcitonin/blood , Spain , Superinfection/diagnosis , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: In the context of the COVID-19 pandemic the risk of misdiagnosis of other causes of respiratory infection is likely. In this work we aim to describe the clinical characteristics, treatment and outcome of pneumococcal infection in COVID-19 patients. PATIENTS AND METHODS: Every COVID-19 patient presenting with concomitant pneumococcal pneumonia during March 2020 in a tertiary teaching Hospital In Barcelona, Spain. RESULTS: Five patients with PCR confirmed COVID19 or clinical and radiological suspicion were diagnosed of pneumococcal infection. In all cases chest X-ray were abnormal, with unilateral or bilateral infiltrates. Procalcitonin showed to be not sensitive enough to detect pneumococcal infection. Antibiotherapy was promptly started in all five cases with subsequent satisfactory evolution. CONCLUSION: International guidelines do not include the universal screening for bacterial co-infection. Radiological pattern of COVID-19 can be indistinguishable from that of pneumococcus pneumonia and frequency of co-infection is not well stablished, therefore clinicians should be aware of the possible SARS-CoV-2-pneumococcus association to avoid misdiagnosis and delay antibiotic therapy.
INTRODUCCIÓN: En el contexto de la pandemia por COVID-19 el riesgo de errores en el diagnóstico de otras causas de infección respiratoria es elevado. En este trabajo describimos las características clínicas, el tratamiento y la evolución de los pacientes con coinfección por COVID-19 y neumococo. PACIENTES Y MÉTODOS: Todos los pacientes con COVID-19 que presentaron neumonía neumocócica durante marzo 2020 en un hospital universitario de Barcelona, España. RESULTADOS: Cinco pacientes con COVID-19 confirmada por PCR o sospecha radiológica fueron diagnosticados de infección por neumococo. En todos los casos la radiografía de tórax era patológica con infiltrado unilateral o bilateral. La procalcitonina demostró no ser suficientemente sensible para detectar la infección neumocócica. La antibioterapia fue iniciada de manera precoz en los 5 casos con evolución satisfactoria. CONCLUSIONES: Las guías internacionales no incluyen el cribado universal para coinfección bacteriana. El patrón radiológico del COVID-19 puede ser indistinguible de la neumonía neumocócica, y la frecuencia de la coinfección no ha sido establecida. Los clínicos deben de ser conscientes de la posible asociación de SARS-CoV-2 y neumococo para evitar errores diagnósticos y retrasos en el tratamiento antibiótico.