Abstract
BackgroundThe spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders. Coexisting multipathogen infections significantly increase the complexity of the proper diagnostic and therapeutic approach and correlate with the rate of intensive care unit admissions and in-hospital mortality.Case presentationWe present a case of multipathogen respiratory infection with severe acute respiratory syndrome coronavirus 2, varicella zoster virus, and polymicrobial tracheobronchitis in a 48-year-old Caucasian male hospitalized after traumatic brain injury. The patient tested positive for severe acute respiratory syndrome coronavirus 2 infection upon admission. During his stay in the intensive care unit, the patient developed a vesicular exanthema along with respiratory failure and signs of septic shock.ConclusionThis case of an adult presenting with severe acute respiratory syndrome coronavirus 2 infection and simultaneous primary varicella zoster virus infection illustrates the importance of considering coinfections in patients with coronavirus disease 2019 with unusual clinical manifestations.
Highlights
The spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 (COVID-19) is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders
The patient was fully sedated with propofol and fentanyl [Glasgow coma scale (GCS) score of 3 points], intubated, and volume-controlled ventilated with a fractional concentration of inspired oxygen (FiO2) of 0.55, positive end expiratory pressure (PEEP) of 7 mbar, and respiratory rate of 17 breaths per minute
Similar average incubation periods of COVID-19 and varicella as well as the timing of clinical manifestations in our patient lead us to the conclusion that varicella zoster virus (VZV) and COVID-19 were in our case community-acquired coinfections
Summary
A possible immunosuppressant effect of SARS-CoV-2 [5] could increase the likelihood of coinfections and influence their severity in patients presenting with COVID-19. Despite the great variety of possible clinical manifestations of COVID-19, a coincidence of rare symptoms and fast cardiopulmonary deterioration should raise suspicion of a concomitant infectious process. This case of an adult presenting with SARS-CoV-2 infection and simultaneous primary VZV infection illustrates the importance of considering coinfections in patients with COVID-19 with unusual clinical manifestations
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
