Diagnostic bias during the COVID-19 era: COVID-19 or renal abscess?

Area of Science:

• Internal Medicine
• Infectious Diseases
• Radiology

Background:

• The Coronavirus disease-2019 (COVID-19) pandemic has significantly impacted global healthcare and patient triage protocols.
• While diagnostic symptoms and tests are often accurate, diagnostic errors remain a concern.
• The pandemic has altered clinical decision-making processes, necessitating careful consideration of differential diagnoses.

Observation:

• A 60-year-old male healthcare worker in a COVID-19 ward presented with weight loss, fatigue, and mild fever.
• Initial diagnosis was mild COVID-19 based on positive swab and chest CT scan.
• A follow-up CT scan revealed a renal lesion initially misidentified as a tumor, later confirmed as an abscess.

Findings:

• The renal abscess was the primary cause of the patient's presenting symptoms.
• The patient's symptoms were initially attributed to COVID-19, leading to a delay in identifying the true underlying condition.
• Misidentification of the renal lesion as a tumor underscores potential diagnostic challenges.

Implications:

• Clinicians must maintain a broad differential diagnosis for patients presenting with symptoms overlapping with COVID-19.
• Considering life-threatening conditions beyond COVID-19 is crucial to avoid diagnostic errors and unnecessary treatments.
• Prompt and accurate diagnosis of conditions like renal abscesses is vital for effective patient management during the pandemic.