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A 38-year-old man developed decrease in WBC count following an off-label use of tocilizumab, indicated for COVID-19 pneumonia and acute pancreatitis. The man had underlying oedematous moderate acute pancreatitis, hepatic steatosis, hepatosplenomegaly and alcohol dependence. On 4 April 2020, he was admitted in hospital of Poland, with positive SARS-CoV-2 (molecular test result obtained on 3 April 2020). He had previously been hospitalised for 2 weeks in another medical centre due to severe acute pancreatitis, presenting with acute-onset upper abdominal pain, metabolic acidosis and features of multi-organ failure. Empiric antimicrobial therapy with vancomycin and imipenem/cilastatin and total parenteral nutrition (TPN) were administered that time. On 27 March 2020, he underwent chest high-resolution CT-scan and abdomen-pelvis contrast-enhanced CT scans, which showed diffuse enlargement, shaggy contour of the pancreas without contrast enhancement of pancreatic neck, body and tail, oedema and blurring of peripancreatic fat planes, acute peripancreatic and intraperitoneal fluid collection, bilateral atelectasis in lower lung segments and pleural fluid collections up to 24mm on the left

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Publisher

Adis International Limited (now part of Wolters Kluwer Health); Springer-Verlag; Springer Science and Business Media LLC (ISSN 0114-9954)

Published

2020

Language

EN

Field

Medicine (Health Sciences)