Since making its debut on the global stage in December 2019, Coronavirus Disease 2019 (COVID-19) has afflicted nearly four million people and caused hundreds of thousands of deaths. Case reports and case series depicting the clinical effects of the causative virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have been published, yet few demonstrate the cytopathologic alterations of this disease. We present a clinical-pathological correlation report of a previously healthy Hispanic woman with laboratory-confirmed COVID-19 who had typical features of acute respiratory distress syndrome (ARDS), and also showed cardiac abnormalities thought to represent fulminant viral myocarditis. Congruent with the ARDS clinical impression, autopsy findings were remarkable for extensive and markedly severe acute lung injury consistent with viral pneumonia, characterized by diffuse alveolar damage, pulmonary infarction, severe pulmonary edema, desquamation of pneumocytes with intraalveolar aggregation, and pneumocyte morphological alterations suspicious for viral cytopathic effect. However, there was incongruence between the clinical impression and the cardiovascular pathology findings in that viral myocarditis was not detected on histopathologic evaluation. This case highlights the importance of pathologic corroboration of the clinical impression and, in addition, illuminates the key role autopsy plays during a pandemic by providing valuable insight into viral pathology in tissues.

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Utilizing PCT guidance in the management of COPD exacerbations was associated with a decreased total duration of antibiotic therapy and hospital LOS without negatively impacting hospital readmissions.

Community-acquired pneumonia (CAP) is a frequent cause of hospitalization in adults. S treptococcus pneumoniae is the most commonly identified pathogen in CAP whereas Legionella pneumophilia is infrequently identified in CAP. Although co-infections have been previously described, the presence of both pneumococcus and legionella together is rare. We present a patient with positive urinary antigens for both Streptococcus pneumoniae and Legionella pneumophilia serogroup 1, indicating an unusual co-infection.