case_images: PMC8053433_01
case_images: (a) A 74-year-old male presenting with cough and lethargy diagnosed with COVID-19. Contrast-enhanced axial chest computed tomography demonstrates bilateral patchy ground glass opacities (red arrows). (b) A left upper extremity gray-scale ultrasound demonstrated acute non-occlusive thrombus (green arrows) in the left axillary veins.
case_images: JCIS-11-16-g001.jpg
case_images: PMC8053433_01_JCIS-11-16-g001.jpg
case_images: F1
case_images: This was negative for an acute PE but showed diffuse patchy ground-glass opacities (GGOs) throughout both lungs [Figure 1a]. Upper extremity ultrasounds performed with color and spectral Doppler analysis demonstrated acute non-occlusive thrombus in the right internal jugular, left subclavian, and left axillary veins [Figure 1b].
case_images: PMC8053433_02
case_images: (a) A 71-year-old female presented to the emergency department with a 2 week history of intermittent fevers, dry cough, shortness of breath, reduced appetite with reduced taste, and diarrhea. A frontal chest radiograph showed bilateral patchy airspace opacities in the lower lungs, greater on the left side (green arrows). (b) Left lower extremity gray-scale ultrasound demonstrates a non-compressible left soleal vein (yellow arrows) with no flow consistent with occlusive deep vein thrombosis.
case_images: JCIS-11-16-g002.jpg
case_images: PMC8053433_02_JCIS-11-16-g002.jpg
case_images: F2
case_images: A chest radiograph showed bilateral patchy airspace opacities in the lower lungs, greater on the left side [Figure 2a]. A lower extremity ultrasound was significant for an acute distal DVT with occlusive thrombus in the left soleal vein [Figure 2b].
case_images: PMC8053433_03
case_images: (a) A 49-year-old male with a 10 day history of progressive shortness of breath, cough, and fevers. Computed tomography of the chest with intravenous contrast demonstrated diffuse bibasilar ground-glass opacities (green arrows), left upper lobe collapse secondary to mucus plugging (blue arrows), and small pleural effusions (yellow arrows) (b) Color flow Doppler ultrasound of the neck demonstrates non-occlusive thrombus in the right internal jugular vein (yellow arrows).
case_images: JCIS-11-16-g003.jpg
case_images: PMC8053433_03_JCIS-11-16-g003.jpg
case_images: F3
case_images: COVID-19 was positive. CT angiogram of the chest with IV contrast was performed and was negative for acute PE, but revealed diffuse GGOs, bibasilar consolidation, left upper lobe collapse secondary to mucus plugging, and small pleural effusions bilaterally [Figure 3a]. The patient was found to have an acute non-occlusive DVT of the right internal jugular vein [Figure 3b].
case_images: (a) A 56-year-male presented to the emergency department with a 10 day history of dry cough and worsening shortness of breath. Initial laboratory tests were notable for an elevated D-dimer. Axial computed tomography of the chest showed diffuse bilateral ground-glass opacities (green arrows). (b) Bilateral upper lobe segmental pulmonary emboli were also present (yellow arrows). (c) A lower limb Doppler color flow ultrasound demonstrated lack of flow in the left peroneal vein (green arrow) in keeping with deep vein thrombosis.
case_images: JCIS-11-16-g004.jpg
case_images: PMC8053433_03_JCIS-11-16-g004.jpg
case_images: F4
case_images: CT chest showed diffuse bilateral GGOs [Figure 4a] and bilateral upper lobe segmental pulmonary emboli [Figure 4b]. A lower limb Doppler ultrasound was positive for acute DVT in the left peroneal vein [Figure 4c].
case_images: PMC8053433_04
case_images: (a) A 63-year-old male who presented to the emergency department with a 10 day history of dry cough, dyspnea, myalgia, and lethargy. Computed tomography of the chest demonstrated diffuse peripheral ground-glass opacities (blue arrows). (b) Axial computed tomography angiography of the chest at the level of pulmonary arteries demonstrated a pulmonary embolus (yellow arrow) in the right lower lobar pulmonary artery. (c) Sagittal color flow Doppler ultrasound demonstrated non-compressible occluded right posterior tibial veins (green arrows).
case_images: JCIS-11-16-g005.jpg
case_images: PMC8053433_04_JCIS-11-16-g005.jpg
case_images: F5
case_images: C-reactive protein of 8.3 mg/dL. CT chest demonstrated diffuse peripheral GGOs [Figure 5a] and a right lower lobar PE [Figure 5b]. Lower limb ultrasound was significant for bilateral posterior tibial DVTs [Figure 5c].