A 54-year-old man presented with a 5-day fever, cough, dyspnea, and chest pain. Physical examination revealed bilateral crackles on lung auscultation; temperature was 39°C. C-reactive protein was 27.2 mg/L (normal range: 0–5 mg/L) and serum lactate level was 274 U/L (normal range: 135–225 U/L); other blood tests showed normal results. COVID-19 was detected in two oropharyngeal swab samples by RT-PCR on consecutive days; Legionella and Streptococcus pneumoniae urinary antigens and PCR for other respiratory viruses on nasopharyngeal swabs were all negative. A bronchoalveolar lavage excluded pulmonary aspergillosis. On day 3, the patient developed severe dyspnea with decreased oxygen saturation (90%). Unenhanced chest computed tomography (CT) imaging showed diffuse bilateral peribronchial consolidations surrounded by ground-glass opacities (Figures 1 and 2).
The typical CT pattern of COVID-19 pneumonia consists of ground-glass opacities (GGO) with bilateral and peripheral distribution.1 However, less common imaging findings have also been reported. A pattern of peribronchial infiltrate with surrounding GGO is not well described in COVID-19, let alone to this extent.2 Radiologists should be aware of the wide spectrum of CT manifestation of this infection.
Zhou Z, Guo D, Li C, Fang Z, Chen L, Yang R, Li X, Zeng W, 2020. Coronavirus disease 2019: initial chest CT findings. Eur Radiol 2020: 1–9.