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.