Main Text
A 30-year-old man presented with a 2-day-history of fatigue, fever
(39.0℃) and cough without sputum and respiratory failure. 6 days ago, he
had participated the banquet and meeting in Tokyo, in which COVID-19 had
been spreading. Laboratory tests showed elevated C-reactive protein
(4.23mg/dL) without the specific findings about any pathogen. Chest CT
revealed only tree-in-bud appearance on the right upper-lobe (Fig.1B)
and centri-lobular nodules with unclear edge on the left lower lobe
without typical ground-glass opacity (GGO) as COVID-19 (Fig. 1A-C).
Diagnosis of COVID-19 was made by RT-PCR from nasopharyngeal swab. He
has received supportive care and the symptoms have improved.
COVID-19 usually demonstrates the specific pattern of Chest CT-findings,
such as GGO, inverted-halo sign, and so on [1,2]. However, it had
been reported that several cases showed only atypical findings or no
significant findings in Chest CT [1,2]. Although the role of CT
images for COVID-19 is extremely high, it is also important to recognize
that some cases show only atypical findings in CT, especially at a
diagnosis. We should not decide whether or not to carry out PCR test
based on CT findings alone. At the time, we physicians should make
comprehensive judgement for this pandemic situation.