Combined variable immunodeficiency (CVID) is a primary immunodeficiency, characterized by impairment in immune system function. These patients are susceptible to opportunistic infections, which may mimic COVID-19 manifestations. Also, misdiagnosis or delayed diagnosis of opportunistic infections can lead to perilous consequences. We report a 28-year-old woman with a history of combined variable immunodeficiency disorder (CVID) and ulcerative colitis (UC) complained of fever, cough, and dyspnea. According to the clinical and radiological manifestations and the COVID-19 epidemic, she was admitted with a primary diagnosis of COVID-19 pneumonia. After a week, the patient did not respond to treatment, so she underwent bronchoscopy. Using polymerase chain reaction (PCR) methodology, we detected DNA of Pneumocystis jirovecii , the causative agent of a life-threatening pneumonia (PCP), in respiratory specimens. The patient was hypersensitive to common PCP treatments, so she was treated with high-dose clindamycin. However, the patient’s clinical condition aggravated. Besides, we found evidence of pneumothorax, pneumomediastinum, and pneumopericardium in chest CT scan. We inserted a catheter for the patient to evacuate the air inside the mediastinum. Also, we added caspofungin to the treatment. The patient eventually recovered and was discharged from the hospital about a week later. Thus, during the COVID-19 epidemic, in febrile patients with respiratory symptoms, physicians should not think only of COVID-19. They must consider opportunistic infections such as PCP, especially in immunocompromised patients.
【저자키워드】 COVID-19, SARS-CoV-2, Case report, common variable immunodeficiency (CVID), pneumocystis pneumonia, 【초록키워드】 Treatment, Pneumonia, hospital, immunodeficiency, Immunocompromised patients, Diagnosis, immune system, cough, Consequences, DNA, PCR, Fever, Dyspnea, Patient, Manifestations, methodology, CVID, opportunistic Infections, ulcerative colitis, Evidence, COVID-19 epidemic, respiratory specimens, chest CT scan, manifestation, Pneumomediastinum, respiratory symptoms, opportunistic infection, High-dose, life-threatening, clinical condition, disorder, physician, impairment, susceptible, radiological, Combined, polymerase chain, the patient, characterized, treated, added, discharged, respond, diagnosis of COVID-19, febrile patient, hypersensitive, 【제목키워드】 variable, Combined,