Een benauwde jongedame tijdens de coronacrisis

Klinische les
22-09-2020
Eline A.M. Zijtregtop, Natasja Dors, Hanneke Bakker, Lisa D. Klasen, Sanne Oegema en Auke Beishuizen

Dames en Heren,

In de afgelopen maanden is de zorg ontregeld geraakt door de coronacrisis, met als gevolg dat de zorg voor patiënten zonder covid-19 in het gedrang is gekomen. Wij beschrijven de casus van een 16-jarig meisje bij wie aanvankelijk werd gedacht aan covid-19. Uiteindelijk werd zij opgenomen op de afdeling Intensive Care Kinderen vanwege respiratoire insufficiëntie, veroorzaakt door een mediastinale tumor.

A young lady with shortness of breath during the coronavirus crisis

A 16-year-old girl repeatedly visited a general practitioner during the coronavirus pandemic for progressive shortness of breath. Progressive orthopnoea was found as well. Her neck was swollen for two weeks and there was generalised itching for months. Given the nature of her symptoms, she was assessed at the coronavirus station. A diagnosis of coronavirus disease 2019 (COVID-19) was assumed. Due to limited testing capacity, the diagnosis was not confirmed. She was treated with supportive treatment that had no effect on her dyspnoea. Tunnel vision ensured that the symptoms that did not fit COVID-19, were not recognised. Moreover, a scheduled ultrasound of her neck was cancelled because of the coronavirus restrictions, which did not help matters. She was eventually admitted to the paediatric intensive care unit with respiratory failure associated with cervical and mediastinal Hodgkin lymphoma.

Conflict of interest and financial support: none declared.