Viral exanthema as manifestation of SARS-CoV-2 infection: A case report. Issue 35 (28th August 2020)

• Record Type: Journal Article
• Authors: Iancu, Gabriela Mariana; Solomon, Adelaida; Birlutiu, Victoria
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 99:Issue 35(2020)
• Publication Date: 2020-08-28
• Subjects: exanthema -- SARS-CoV-2 -- anosmia -- clinical manifestations -- immune response; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000021810
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: The clinical manifestations of the SARS-CoV-2 infection are mainly respiratory but the virus can cause a variety of symptoms. Dermatological findings are less well-characterized. Data is scarce on their timing, type and correlation with the immune response. Patient concerns: We present the case of SARS-CoV-2 infection in a previously healthy woman who presented with respiratory symptoms and developed anosmia, diarrhea, and an erythematous maculo-papular rash on day 15 from symptom onset. Diagnosis: The nasopharyngeal swab tested by real time PCR for COVID-19 was positive. We interpreted this as a viral exanthema likely caused by an immune response to SARS-CoV-2 nucleotides. Interventions: She was treated with Hydroxychloroquine, Azithromycin and Lopinavir/Ritonavir, and the rash with topical corticosteroids. Outcomes: All symptoms resolved except for anosmia which persisted for 6 weeks. At the 4- and 6-weeks follow-up the IgG titers for SARS-CoV-2 were high. Lessons: We must consider that SARS-CoV-2 has a multi-organ tropism. In our case, the SARS-CoV-2 infection had lung, nasopharyngeal, neurological, digestive, and skin manifestations. Identifying the different manifestations is useful for understanding the extent of SARS-CoV-2 infection. We not only present a rare manifestation but also suggest that cutaneous manifestations may correlate with immunity.