Case: 8 YO Boy with Weeklong Fever, Sore Throat

AJR authors: Sharon Steinberger, Bin Lin, Adam Bernheim, Michael Chung, Yuantong Gao, Zongyu Xie, Tongtong Zhao, Junli Xia, Xueyan Mei, Brent P. Little

History

8-year-old boy with fever and sore throat for 7 days; abnormal WBC count at hospital admission within normal limits.

Imaging Findings

mage via AJR article “CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients”

Unenhanced chest CT scans show minimal ground-glass opacities (in right lower and left upper lobes) (arrows) and no consolidation. Only two lobes were affected, and CT findings were assigned CT severity score of 2.

Correct Answer: Coronavirus Disease (COVID-19)

Steinberger and colleagues’ review of the CT findings and clinical symptoms of 30 pediatric patients (aged 10 months to 18 years) who tested positive for COVID-19 via quantitative real-time reverse transcription–polymerase chain reaction at six centers in China from January 23 to February 8, 2020 revealed a high frequency (77%) of negative chest CT findings. Consistent with reported symptomatology in children, the authors of this AJR article also observed a correlation between increasing age and increasing severity of findings. Further questioning the utility of CT in the diagnosis and management of COVID-19 in children, 11 of 30 patients (37%) underwent follow-up chest CT—with 10 of 11 examinations (91%) showing no change.

Suggested Readings

Learn more by reading this open-access article “CT Features of Coronavirus Disease (COVID-19) in 30 Pediatric Patients.” The latest AJR Podcast episode details both chest CT and chest radiography in pediatric patients with COVID-19, including characteristic imaging findings and recommendations. Please find additional open-access resources on our COVID-19 microsite.