NEW DELHI: Pulmonary alveolar proteinosis (PAP), a rare disease mimics clinically and radiologically with COVID-19 infection. However, both are different. They can complicate and cause a diagnostic dilemma when they co-exist, suggests a new study conducted by AIIMS-Delhi.
The study notes that pathophysiology and the management of PAP and COVID-19 are different. Any delay in diagnosing these two diseases can lead to poor patient outcomes by failing to isolate a COVID-19 case. The study says that PAP severity varies from mild to severe. It gives dyspnea, cough, hemoptysis with or without fever.
The clinical picture of the disease varies from a milder form of fever, dry cough with or without expectoration, to severe disease-causing respiratory distress, pneumonia, acute respiratory distress syndrome, and can even lead to death.
Radiologically, the findings of COVID-19 are similar to those of PAP. PAP mimics the COVID-19, posing a differential challenge. Therefore, for proper management of the disease, it is important to differentiate it from other pathologies.
In a rare case report at the AIIMS, a 34-year old female patient, who was a known case of autoimmune pulmonary alveolar proteinosis, came with an acute exacerbation in the emergency department and tested positive for COVID-19.
"We followed a systematic approach consisting of clinical, laboratory, radiologic parameters to differentiate the cause of this exacerbation. The lady, known case of autoimmune 'PAP', presented to the hospital with a history of low-grade fever, breathing difficulty, and dry cough from the last four days in the emergency department. She was diagnosed with PAP two years back. She had received one total lung lavage (TLL) therapy for the same," the study narrates.
Following admission at the AIIMS, she was to undergo another session of TLL when during pre-procedure workup she tested positive for COVID-19. Her stay in ICU was eight days. She underwent TLL therapy and was finally discharged.
PAP SYMPTOM
The clinical picture of the disease varies from a milder form of fever, dry cough with or without expectoration, to severe disease-causing respiratory distress, pneumonia and acute respiratory distress
Delhi reports 30 fresh COVID cases
NEW DELHI: The city reported 30 fresh COVID-19 cases and zero fatality on Wednesday, while the positivity rate stood at 0.04 per cent, according to the city government’s health bulletin. The cumulative case tally of Delhi stands at 14, 38,586, while over 14.13 lakh people have either been discharged or have recovered or migrated out, the bulletin said.
Nineteen patients have been discharged in the last 24 hours. The death toll remains at 25,085 and the case fatality rate is 1.74 per cent, it stated. The bulletin said that 70,651 tests were conducted on the previous day, of which 49,728 were RT-PCR tests, while the rest rapid antigen tests.
More than 2.10 lakh people were vaccinated against coronavirus and over 1.11 lakh of them got the first dose, according to official data. As many as 49.98 lakh people have received both the doses. According to the government's data, the city had around 9 lakh vaccine doses, 1.22 lakh Covaxin and 7.72 lakh Covishield on Tuesday.