The Role of Chest Radiograph, Procalcitonin and Moxifloxacin in Diagnosis and Management of Breast Cancer Patients with COVID-19

Ikhwan Rinaldi, Abdul Muthalib, Pujo Astowo, Bambang Irawan, Nelly Susanto, Lingga Magdalena, Ilham H.R. Tulus Maha, Satrio Wicaksono

Abstract


Global widespread of current coronavirus disease 2019 (COVID-19) pandemic has emerged huge predicament to healthcare systems globally. This disease caused by a new beta-type coronavirus, known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), may lead to systemic multiorgan dysfunction syndrome and subsequently cause death due to abundant angiotensin converting enzyme 2 as its functional receptors throughout body. Oncology patients even have a worse prognosis with greater infection susceptibility because they are in a state of suppression of the systemic immune system due to malignancy and anticancer therapy. This problem makes adequate and appropriate treatment urgently needed. Through randomized clinical trials, various drugs were known to have good responses in COVID-19 patients. Here, we reported a-49-year-old-woman that was confirmed for COVID-19 by clinical manifestation, radiology profile, high procalcitonin concentration, and positive polymerase chain reaction (PCR) test. The patient also had breast and thyroid cancers history and had undergone various therapeutic modalities such as chemotherapy, thyroid surgery, and breast surgery. She was undergoing hormone therapy but experiencing disease progression after achieving complete remission based on PET-CT scan 4 months before. The patient was treated with various antibiotics but showed a significant clinical improvement by administering moxifloxacin.


Keywords


COVID-19; SARS-CoV-2; breast cancer; chest radiograph; moxifloxacin; procalcitonin

References


Hamid S, Mir MY, Rohela GK. Novel coronavirus disease (COVID-19): a pandemic (epidemiology, pathogenesis and potential therapeutics). New Microbes New Infect. 2020;35:100679. Published 2020 Apr 14. Available from: https://www.sciencedirect.com/science/article/pii/S2052297520300317.

Verdecchia P, Cavallini C, Spanevello A, Angeli F. The pivotal link between ace2 deficiency and sars-cov-2 infection. Eur J Intern Med. 2020;76(April):14–20. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0953620520301515.

Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect. 2020;80(6):656-65. Available from: https://www.sciencedirect.com/science/article/pii/S0163445320301705.

Liang W, Guan W, Chen R, et al. Cancer patients in sars-cov-2 infection: a nationwide analysis in china. Lancet Oncol. 2020;21(3):335-7. Available from: https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(20)30096-6.pdf.

Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5. Available from: https://www.sciencedirect.com/science/article/pii/S1201971220301363.

Yang W, Sirajuddin A, Zhang X, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). Eur Radiol. 2020;1-9. Available from:10.1007/s00330-020-06827-4.

Jacobi A, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19): A pictorial review. Clin Imaging. 2020;64:35-42. Avalable from: 10.1016/j.clinimag.2020.04.001.

Yoon SH, Lee KH, Kim JY, et al. Chest radiographic and ct findings of the 2019 novel coronavirus disease (covid-19): analysis of nine patients treated in korea. Korean J Radiol. 2020;21(4):494-500. Available from:10.3348/kjr.2020.0132.

Slanetz PJ, Parikh U, Chapman T, Motuzas CL. Coronavirus disease 2019 (covid-19) and radiology education-strategies for survival. J Am Coll Radiol. 2020;17(6):743-745. Available from:10.1016/j.jacr.2020.03.034.

Muller F, Crain MC, Bregenzer T, et al. Procalcitonin levels predict bacteremia in patients with community-acquired pneumonia: a prospective cohort trial. Chest. 2010; 138(1):121-9. Available from: https://journal.chestnet.org/article/S0012-3692(10)60356-X/fulltext.

Huijskens EGW, Van Erkel AJM, Palmen FMH, Buiting AGM, Kluytmans JAJW, Rossen JWA. Viral and bacterial aetiology of community-acquired pneumonia in adults. Influenza Other Respi Viruses. 2013; 7(4):547-73. Available from: https://core.ac.uk/reader/232453612.

Rawson TM, Moore LSP, Zhu N, et al. Bacterial and fungal co-infection in individuals with coronavirus: a rapid review to support covid-19 antimicrobial prescribing. Clin Infect Dis. 2020;ciaa530. Available from:10.1093/cid/ciaa530.

Kuzman I, Bezlepko A, Kondova Topuzovska I, et al. Efficacy and safety of moxifloxacin in community acquired pneumonia: a prospective, multicenter, observational study (caprivi). BMC Pulm Med. 2014;14:105. Published 2014 Jun 30. Available from:10.1186/1471-2466-14-105.

Cooley L, Dendle C, Wolf J, et al. Consensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014. Intern Med J. 2014;44(12b):1350-63. Available from:10.1111/imj.12599.

Bollée G, Sarfati C, Thiéry G, et al. Clinical picture of pneumocystis jiroveci pneumonia in cancer patients. Chest. 2007;132(4):1305-1310. Available from:10.1378/chest.07-0223.

Wu R, Wang L, Kuo HD, et al. An update on current therapeutic drugs treating COVID-19. Curr Pharmacol Rep. 2020;1-15. Available from:10.1007/s40495-020-00216-7.

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-62. Available from:10.1016/S0140-6736(20)30566-3.


Full Text: PDF

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 Acta Medica Indonesiana