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Case Reports
. 2024 Nov 14;16(11):e73673.
doi: 10.7759/cureus.73673. eCollection 2024 Nov.

A Complex Case of COVID-19 Pneumonitis in a Patient With Follicular Lymphoma

Ameya Elizabeth Benedict  1 , Graham Hantman  2 , Kavitha Paul  1 , Saeed Akbar  2
Affiliations
Case Reports

A Complex Case of COVID-19 Pneumonitis in a Patient With Follicular Lymphoma

Ameya Elizabeth Benedict et al. Cureus. .

Abstract

Protracted COVID-19 is increasingly recognised in immunocompromised patients, particularly those with haematological malignancies. Here, we present the case of a patient with protracted COVID-19 and an underlying B-cell malignancy. Standard COVID-19 treatment with remdesivir and steroids proved ineffective in this patient as she continued to have evolving ground-glass opacities on imaging. A multidisciplinary involvement altered treatment to include a combination of antivirals nirmatrelvir/ritonavir (Paxlovid) and remdesivir, a monoclonal antibody and immunoglobulins leading to a clinical cure. This report highlights the need for a more tailored approach in this patient sub-group than the rest of the population.

Keywords: covid-19; cycle threshold; ground-glass opacity; hematologic malignancy; immunocompromised.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest radiograph on day 36 showing bilateral ground-glass changes in the lower hemithorax.
Figure 2
Figure 2. CT of the thorax on day 51 showing evolving ground-glass opacifications.
Figure 3
Figure 3. CT of the thorax on day 72 suggestive of Pneumocystis jirovecii infection.
Figure 4
Figure 4. Chest radiograph showing radiological improvement of ground-glass changes after treatment with monoclonal antibody, antivirals, and immunoglobulins.
See this image and copyright information in PMC

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