Clinical Practice and Cases in Emergency Medicine (Aug 2020)

Crazy-Paving: A Computed Tomographic Finding of Coronavirus Disease 2019

  • Megan Gillespie,
  • Patrick Flannery,
  • Jessica A. Schumann,
  • Nathan Dincher,
  • Rebecca Mills,
  • Argun Can

DOI
https://doi.org/10.5811/cpcem.2020.5.47998
Journal volume & issue
Vol. 4, no. 3

Abstract

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Introduction: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. 1 COVID-19 first occurred in Wuhan, China, in December 2019, and by March 2020 COVID-19 was declared a global pandemic. 1 Case Presentation: We describe a case of a 52-year-old female with past medical history of asthma, type 2 diabetes, and previous tobacco use who presented to the emergency department with dyspnea and was found to be positive for COVID-19. We discuss the computed tomographic finding of “crazy-paving” pattern in the patient’s lungs and the significance of this finding in COVID-19 patients. Discussion: Emergency providers need to be aware of the different imaging characteristics of various stages of COVID-19 to appropriately treat, isolate, and determine disposition of COVID-19 infected patients. Ground-glass opacities are the earliest and most common imaging finding for COVID-19. 2– 4 Crazy-paving pattern is defined as thickened interlobular septa and intralobular lines superimposed on diffuse ground-glass opacities and should be recognized by emergency providers as a radiographic finding of progressive COVID-19. 2– 4