3 Methods:
At the admission, the patient weighed 78 kg with a BMI of 30 kg/m2. The patient is a non-smoker, doesn’t consume alcohol, and has no underlying health conditions. Vital signs on admission showed a temperature of 39.1°C, a pulse rate of 78 beats per minute, and blood pressure reading 110/79 mm Hg. Although the respiratory rate was slightly elevated at 25 breaths per minute, the patient maintained 99% oxygen saturation in room air and showed no signs of dehydration. Physical examination did not reveal any abnormal findings.
Considering the symptoms presented in the case, our differential diagnosis includes COVID-19, dengue fever, chikungunya, and other arbovirus diseases, as well as malaria. We proceeded with relevant laboratory tests based on this list to work towards a definitive diagnosis. However, the ongoing conflict and lack of access to upper gastrointestinal (GI) endoscopy posed a challenge in ruling out the possibility of a GI ulcer as a contributing factor.
The patient tested positive for COVID-19 through RT-PCR. A chest X-ray revealed pneumonia, showing ill-defined ground-glass opacifications in the lower regions of both lungs. Due to concerning symptoms like vomiting blood and prolonged fever, a blood sample was sent for detecting dengue virus and other arbovirus diseases. The patient’s serum tested positive for recent dengue virus infection with ELISA IgM antibodies present, while IgG antibodies were not detected. Additionally, a complete blood count was conducted as outlined in Table 1. Furthermore, blood film for malaria parasite was negative.