P5‐16: Lung transplantation cases with nontuberculous mycobacteriosis

Background: About 20% of COVID-19 patients remain PCR positive for SARS-CoV-2 over a few weeks.We report a case of recurred exacerbations and remissions of COVID-19 pneumonia in a patient with B-cell lymphoma undergoing chemotherapy.Case: The patient was a 68-year-old woman who was undergoing chemotherapy with bendamustine and rituximab for B-cell lymphoma at our outpatient clinic.On the day of treatment, a family member became PCR positive for SARS-CoV-2 and the patient was also found to be positive the next day.Chest CT showed ground glass opacities (GGOs) scattered in the lower right lobe, and she was hospitalized for COVID-19 pneumonia.She had neutropenia, fever, and inflammatory findings due to the chemotherapy during the course of the illness, and she was administered G-CSF preparation and various antibiotics.On the 26th day (D26) of illness, chest CT showed expansion of the GGOs in both lung fields.For this exacerbation of COVID-19 pneumonia, administration of dexamethasone, dalteparin sodium, and remdesivir was started on the same day.Chest X-ray on the D40 of illness showed improvement in the GGOs in both lung fields.On the D52 of illness, fever persisted, inflammatory findings worsened, ferritin levels increased sharply, and chest CT showed exacerbation of the GGOs.A PCR test on the D54 of illness was positive, and re-exacerbation of COVID-19 pneumonia was considered.On the D61 of illness, no antibodies of IgM and IgG to SARS-CoV-2 was detect.Conclusion: Persistent SARS-CoV-2 infection may cause relapse or exacerbation of COVID-19 pneumonia in immunocompromised patients.