Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was firstly identified in China and has been declared a global pandemic. Several serious extrapulmonary manifestations due to SARS-CoV-2 infection have also been reported and associated with hypercoagulability thrombotic vasculopathy. In addition, cases of Mycobacterium-leprae infection have also been known associated with blood coagulation abnormality. Methods: Here, we report a 56-year-old male with coronavirus disease-19 (COVID-19) with concomitant leprosy infection with manifestation of glans penile necrosis, presented to the emergency department with acute penile pain. This case is unique because no occlusion blood flow to the penile was observed in the radiographic imaging. We described the potential pathophysiology in this case through a literature review. Results: The patient received treatment according to the COVID-19 protocol and was given low molecular weight heparin (LMWH) therapy for 4 days. During the follow up, the clinical and functional condition of the penis showed significant improvement. Conclusions: Microthrombus involvement, platelet abnormalities and impaired hemostasis due to SARS-CoV-2 and leprosy co-infection are the hypothesis in this case report.
Highlights
At the beginning of 2020, the World Health Organization declared novel coronavirus disease-2019 (COVID-19) infection as a pandemic which caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) that has led to a global health crisis due to acute respiratory distress syndrome (ARDS).[1]
Four terms related to the patient’s condition were combined in the searching strategy; 1) Penile; 2) Penis; 3) COVID-19 and 4) SARS-CoV-2 to investigate the relationship between COVID-19 and leprosy infection in necrosis of glans penis
Penile necrosis is linked to thrombotic events and calcium deposits in dialysis patients.[13]
Summary
At the beginning of 2020, the World Health Organization declared novel coronavirus disease-2019 (COVID-19) infection as a pandemic which caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) that has led to a global health crisis due to acute respiratory distress syndrome (ARDS).[1]. 50% of patients with leprosy are affected by a reactional episode,[10] which occurs because of endothelial inflammation leading to necrotizing pan-vasculitis This condition, in severe cases, progresses to necrotic hemorrhagic lesions of the extremities and trunk, as well as Lucio's phenomenon.[11,12]. Case report A 56-year-old Indonesian male patient was admitted to Dr Zainoel Abidin General Hospital in Aceh, Indonesia He was referred from a regional hospital with SARS-CoV-2 infection and necrotic penile glans. After 4 days of LMWH administration without any treatment changes, the clinical condition of the gland penile was improved, the necrosis was less extensive and limited to one-third of the superficial of the glans penis (Figure C). The patient was satisfied with the treatment that he received
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