• Kazuha Nakamura, Mayu Hikone, Hiroshi Shimizu, Yusuke Kuwahara, Maki Tanabe, Mioko Kobayashi, Takuto Ishida, Kazuhiro Sugiyama, Takuya Washino, Naoya Sakamoto, and Yuichi Hamabe.
• Tertiary Emergency Medical Center (Trauma and Critical Care), Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
• J. Infect. Chemother. 2020 Jul 1; 26 (7): 756-761.

IntroductionAn ongoing outbreak of a novel coronavirus disease (coronavirus disease 2019, COVID-19) has become a global threat. While clinical reports from China to date demonstrate that the majority of cases remain relatively mild and recover with supportive care, it is also crucial to be well prepared for severe cases warranting intensive care. Initiating appropriate infection control measures may not always be achievable in primary care or in acute-care settings.CaseA 45-year-old man was admitted to the intensive care unit due to severe pneumonia, later confirmed as COVID-19. His initial evaluation in the resuscitation room and treatments in the intensive care unit was performed under droplet and contact precaution with additional airborne protection using the N95 respirator mask. He was successfully treated in the intensive care unit with mechanical ventilation and extracorporeal membrane oxygenation for respiratory support; and antiretroviral treatment with lopinavir/ritonavir. His total intensive care unit stay was 15 days and was discharged on hospital day 24.ConclusionsStrict infection control precautions are not always an easy task, especially under urgent care in an intensive care unit. However, severe cases of COVID-19 pneumonia, or another novel infectious disease, could present at any moment and would be a continuing challenge to pursue appropriate measures. We need to be well prepared to secure healthcare workers from exposure to infectious diseases and nosocomial spread, as well as to provide necessary intensive care.Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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