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BMC Infect Dis. The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report

tetano

Editor, Senior Moderator
BMC Infect Dis. 2020 Apr 30;20(1):317. doi: 10.1186/s12879-020-05045-z.
The novel coronavirus (COVID-19) pneumonia with negative detection of viral ribonucleic acid from nasopharyngeal swabs: a case report.


Zhang P[SUP]1[/SUP], Cai Z[SUP]2[/SUP], Wu W[SUP]1[/SUP], Peng L[SUP]1[/SUP], Li Y[SUP]1[/SUP], Chen C[SUP]1[/SUP], Chen L[SUP]1[/SUP], Li J[SUP]1[/SUP], Cao M[SUP]1[/SUP], Feng S[SUP]1[/SUP], Jiang X[SUP]1[/SUP], Yuan J[SUP]1[/SUP], Liu Y[SUP]1[/SUP], Yang L[SUP]3[/SUP], Wang F[SUP]4[/SUP].

Author information




Abstract

BACKGROUND:

The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs.
CASE PRESENTATION:

We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged.
CONCLUSION:

This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.



KEYWORDS:

Bronchoalveolar-lavage fluid; COVID-19; Coronavirus; Pneumonia; Tracheoscopy


PMID:32354369DOI:10.1186/s12879-020-05045-z
 
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