A COVID-19 patient with multiple negative results for PCR assays outside Wuhan, China: a case report

Autor: Hao Li, Zhi Wu, Li Da Chen, Yu Ming Ye, Li Lin, Wei Liang Zhang, Ya Ping Huang
Rok vydání: 2020
Předmět:
Adult
Male
0301 basic medicine
China
medicine.medical_specialty
False negative
Fever
Isolation (health care)
Radiography
Pneumonia
Viral
030106 microbiology
Case Report
Real-Time Polymerase Chain Reaction
Sensitivity and Specificity
lcsh:Infectious and parasitic diseases
Betacoronavirus
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Internal medicine
medicine
Humans
lcsh:RC109-216
030212 general & internal medicine
Pandemics
Lung
Coronavirus disease 2019
medicine.diagnostic_test
SARS-CoV-2
business.industry
Uncertainty
COVID-19
Outbreak
Nucleic acid test
Lopinavir
Real-time RT-PCR
Hospitalization
Infectious Diseases
medicine.anatomical_structure
Methylprednisolone
Quarantine
Coronavirus Infections
Tomography
X-Ray Computed
business
Negative Results
severe acute respiratory syndrome coronavirus 2
medicine.drug
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-4 (2020)
ISSN: 1471-2334
0924-8579
DOI: 10.1186/s12879-020-05245-7
Popis: Background The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a public health emergency of major international concern. Real-time RT-PCR assays are recommended for diagnosis of COVID-19. Here we report a rare case of COVID-19 with multiple negative results for PCR assays outside Wuhan, China. Case presentation A 32-year old male was admitted to our hospital because of 6 days of unexplained fever on January 29, 2020. He had come from Wuhan city 10 days before admission. Five days before admission, no abnormality was noted in laboratory test, chest radiography, and nasopharyngeal swab test for the SARS-CoV-2 nucleic acid. The patient was treated with ibuprofen for alleviating fever. On admission, chest computed tomography showed multiple ground-glass opacities in right lower lung field. COVID-19 was suspected. Three times of nasopharyngeal swab specimens were collected after admission. However, none of the specimens were positive. The patient was confirmed with COVID-19 after fifth SARS-CoV-2 nucleic acid test. He was treated with lopinavir/ritonavir, recombinant human interferon alfa-2b inhalation, methylprednisolone. After 18 days of treatment, he was discharged with improved symptoms, lung lesions and negative results of nasopharyngeal swab. Conclusion This case reminds clinician that a patient with high clinical suspicion of COVID-19 but multiple negative RT-PCR result should not be taken out of isolation. A combination of patient’s exposure history, clinical manifestations, laboratory tests, and typical imaging findings plays a vital role in making preliminary diagnosis and guide early isolation and treatment. Repeat swab tests are helpful in diagnosis for this kind of patients.
Databáze: OpenAIRE
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