International Review of Medical Practice, 2020, XXVI/4: 175-180 Maximize

International Review of Medical Practice, 2020, XXVI/4: 175-180

Title: Image of „crazy-paving pattern” in computed tomography during the COVID-19 pandemia – a case report 

Authors: Płusa T, Konieczny R, Baranowska J, Baranowska A, Baranowski P. 

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Image of „crazy-paving pattern” in computed tomography during the COVID-19 pandemia – a case report

Płusa T1, Konieczny R2, Baranowska J2, Baranowska A2, Baranowski P2.

1Medical Faculty of Łazarski University, Warsaw, Poland; 2Department of Neuroorthopedic, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland;

International Review of Medical Practice, 2020; Vol. 26, No. 4, 175

Changes in the lung parenchyma in the chest tomography (CT) in the form of a „ground glass” and „crazy-paving pattern” image are characteristic for COVID-19 pneumonia in patients infected with SARS-CoV-2.
A case report
. A 20-year-old woman was admitted to a regional hospital due to a multi-site injury suffered in a car accident. The CT examination revealed a dislocation in the cervical spine at the C6/C7 level, left-sided, C7 vertebral fracture, C5 trans-articular fracture and the image of the „crazy-paving pattern” in the upper lobes of the lungs, more intensified on the left side. The epidemic history of the patient’s contact with people infected with SARSCoV- 2 was negative, as were the tests performed. Nevertheless, the patient was isolated. Due to the injuries of the cervical spine, the patient, on the 3rd day after the injury, she was sent to surgical treatment at the Masovian Rehabilitation Center STOCER in Konstancin. The RT-PCR test for the presence of SARS-CoV-2 in the blood was repeated, with the negative result, radiological examination of the chest revealed no changes in the lung parenchyma. The patient was qualified for urgent surgery. A torn intervertebral disc was excised, a reduction of luxation, spondylodesis with interbody cage and cervical plate fixation were performed. The postoperative course was uneventful. On the third day after surgery, a control CT scan of the chest was performed, which showed the disappearance of the changes described in the first examination.
. The changes in the chest CT image were the result of contusion of the lungs, especially the left one. The lack of confirmation of SARS-CoV-2 infection and the absence of changes in the physical examination of the lungs excluded the possibility of COVID-19 coexistence. The described case, however, indicates the need to maintain all diagnostic procedures, which are so important during the current pandemic.

Key words: crazy-paving pattern, chest CT, spine trauma