Reinterpretation of Community-Acquired Pneumonia

An 8 year-old boy with a history of: Chronic lung disease of prematurity, Cough-variant asthma, presented to the emergency in spring 2020 with acute onset of: Dry cough, Shortness of breath, and Fever. No recent travel.

However, his mother is a health care worker at a hospital, and sick contacts included ongoing contact with a friend with “cold-like symptoms.”

He had a variety of animals at home, including a dog, cats, fish, rodents, and reptiles.

Fever and respiratory symptoms were associated with fatigue, chest tightness, abdominal pain, and myalgia.

Workup done, with three PCR test for Covid-19, were negative, and on the fifth day, after major clinical deterioration a fourth PCR test came positive.

A difficult and very unusual challenging with wide range of differential diagnosis, case in the middle of the Covid-19 storm.