Prolonged SARS-CoV-2 Viremia in an Immunocompromised Patient
Abdulrasak, Mohammed LU
and Hootak, Sohail
(2025)
In Journal of Medical Cases
16(1).
p.6-10
- Abstract
Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise. During the investigation, which... (More)
Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise. During the investigation, which encompassed a wide range of microbiological and immunological tests, the patient was initially thought to have a flare of GPA which she was treated for without appreciable improvement, then for multiple microbiological organisms without appropriate resolution of the patient's symptoms. The differential diagnosis of prolonged SARS-CoV-2 infection was reconsidered in October 2023, and then confirmed by the presence of SARS-CoV-2 viremia through polymerase chain reaction (PCR) testing of the blood. The patient received a prolonged course of antiviral therapy with complete clinical, virological and radiological resolution. Prolonged SARS-CoV-2 infection with viremia in immunocompromised individuals needs to be considered on the differential diagnosis list in such patients presenting with constitutional symptoms, with PCR testing of the blood as a simple and effective way to establish the diagnosis.
(Less)
- author
- Abdulrasak, Mohammed
LU
and Hootak, Sohail
- organization
- publishing date
- 2025-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Medical Cases
- volume
- 16
- issue
- 1
- pages
- 6 - 10
- publisher
- Elmer Press
- external identifiers
-
- pmid:39759167
- ISSN
- 1923-4155
- DOI
- 10.14740/jmc5064
- language
- English
- LU publication?
- yes
- additional info
- Copyright 2025, Abdulrasak et al.
- id
- fdc31a20-d3cb-4cb2-beaf-0fe3cec075b6
- date added to LUP
- 2025-01-07 19:22:59
- date last changed
- 2025-04-04 15:22:54
@article{fdc31a20-d3cb-4cb2-beaf-0fe3cec075b6,
abstract = {{<p>Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise. During the investigation, which encompassed a wide range of microbiological and immunological tests, the patient was initially thought to have a flare of GPA which she was treated for without appreciable improvement, then for multiple microbiological organisms without appropriate resolution of the patient's symptoms. The differential diagnosis of prolonged SARS-CoV-2 infection was reconsidered in October 2023, and then confirmed by the presence of SARS-CoV-2 viremia through polymerase chain reaction (PCR) testing of the blood. The patient received a prolonged course of antiviral therapy with complete clinical, virological and radiological resolution. Prolonged SARS-CoV-2 infection with viremia in immunocompromised individuals needs to be considered on the differential diagnosis list in such patients presenting with constitutional symptoms, with PCR testing of the blood as a simple and effective way to establish the diagnosis.</p>}},
author = {{Abdulrasak, Mohammed and Hootak, Sohail}},
issn = {{1923-4155}},
language = {{eng}},
number = {{1}},
pages = {{6--10}},
publisher = {{Elmer Press}},
series = {{Journal of Medical Cases}},
title = {{Prolonged SARS-CoV-2 Viremia in an Immunocompromised Patient}},
url = {{http://dx.doi.org/10.14740/jmc5064}},
doi = {{10.14740/jmc5064}},
volume = {{16}},
year = {{2025}},
}