RESUMO
Background: Currently, there are few studies that have analyzed the benefits of using lung ultrasound in the field of primary care, including in homes and nursing homes, for patients with suspected COVID-19 pneumonia and subsequent follow-ups. The aim of this study was to demonstrate that lung ultrasound is a useful technique for triaging these patients. Methods: An observational and retrospective study of individuals who presented with clinical suspicion of SARS-CoV-2 pneumonia was carried out during the months of March to June 2020 in Health Center number 2 of Ciudad Real and in homes of patients and nursing homes belonging to the Health Service of Castilla-La Mancha (Spain). Results: A total of 209 patients, of whom 86 (41.1%) were male, were included in the study. The most frequent ultrasound findings were bilateral B-lines, with a right predominance, specifically in the posterobasal region. Additionally, there was a statistical significance (p < 0.05) correlation between pathological positivity on lung ultrasound and PCR and chest X-ray positivity. When calculating the sensitivity and specificity of ultrasound and X-ray, ultrasound had a sensitivity of 93%, and X-ray had a sensitivity of 75%. Conclusion: Due to its high sensitivity and negative predictive value, lung ultrasound is very useful as a triage tool for patients with suspected SARS-CoV-2 pneumonia.
RESUMO
Presentamos un caso de tiroiditis subaguda en un hombre de 51 años que comienza con sintomatología inespecífica de febrícula e intensa astenia de días de evolución. De profesión veterinario, la primera sospecha es de picadura de garrapata, y se solicita en primera instancia una analítica completa con serología y una radiografía de tórax. A los 4 días ya disponemos del resultado de las pruebas solicitadas, y llaman nuestra atención unos valores de reactantes de fase aguda elevados, así como una hormona estimulante de la tiroides (TSH) suprimida con valor de T4 libre de 2,56 ng/dl. En ese mismo momento, ante la sospecha de un cuadro de tiroiditis subaguda, realizamos una ecografía tiroidea y obtenemos imágenes compatibles con nuestra sospecha. Comenzamos tratamiento con antinflamatorios no esteroideos, continuando con corticoides y controles ecográficos periódicos en nuestra consulta, hasta resolución del cuadro clínico. La tiroiditis de De Quervain es una patología que, dada la clínica inespecífica con la que puede presentarse y su resolución espontánea, es posible que pase desapercibida en nuestras consultas de Atención Primaria.(AU)
We report a case of subacute thyroiditis in a 51-year-old man who began to present non-specific symptoms of low grade fever and intense asthenia of a few days clinical course. A vet by profession, the initial suspicion was tick bite. Full analysis with serology and chest x-ray was initially requested. After four days we received the results of the tests requested. Some high acute phase reactant values and a depressed TSH with a free T4 value of 2.56 ng/dl were notable. At this same time, given the suspicion of symptoms of subacute thyroiditis, we performed thyroid ultrasound and obtained images compatible with our suspicions. We commenced treatment with NSAIDs and continued corticosteroids and periodic ultrasound controls in our consultation, until the clinical picture resolved. De Quervain thyroiditis is a pathology which - given the non-specific clinical symptoms it can begin with and their spontaneous resolution - may go unnoticed in our primary care consultations.(AU)
