Abstract
A 50-year-old man positive for HIV who developed coronavirus disease 2019 (COVID-19) pneumonia was admitted in our hospital in August 2021 during the fifth wave in Japan of the COVID-19 pandemic caused by a delta variant of severe acute respiratory syndrome coronavirus 2. His white blood cell count and serum C-reactive protein levels were 3,100/μL and 9.0 mg/dL, respectively. His chest X-ray revealed a bilateral ground-glass opacity. Although he was treated with antibiotics and antiviral agents, he needed 118 days of mechanical ventilation. His respiratory management was challenging because he developed pneumomediastinum twice. Because the antibiotics and antiviral agents had limited effect, we administered corticosteroid under the diagnosis of organizing pneumonia. He was discharged after 187 days following improvement of the pneumonia. During the fifth wave of the COVID-19 pandemic in Japan, the Japanese medical system was burdened by an overwhelming patient load. Because our hospital only had two pulmonary specialists, a diabetologist team took responsibility for this case. Despite the case overwhelming the non-specialists and medical staff, all physicians played their roles efficiently, successfully using their general medicine skills and knowledge.
