Abstract
Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. He had no known contact with infected persons. He initially presented with a productive cough, fever, shortness of breath on exertion, intense asthenia and palpitations. The real time PCR with upper airway samples was conducted on days 18 and 20 of the onset of symptoms and was negative. Despite chest CT abnormalities, the patient was not considered to be infected SARS-CoV-2 according to national recommendations for diagnosis and treatment in Benin. He was discharged from the treatment centre. Readmitted 7 days later to the emergency room for respiratory distress, the patient died. Conclusion. Diagnosis of SARS-CoV-2 infection can be difficult. In the context of typical clinical presentation, chest CT features of viral pneumonia may be strongly suspicious for SARS-CoV-2 despite negative real time PCR results. In order to improve the diagnostic and therapeutic strategy for SARS-CoV-2 infection in Benin, chest CT and other diagnostic tests/ criteria should be adopted.
Highlights
On 31 December 2019, China notified WHO about a cluster of pneumonia cases of unknown causes in Wuhan, Hubei province
The causative pathogen, was later identified and named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the Coronavirus Study Group of the International Committee on Taxonomy of Viruses based on its phylogeny, taxonomy, and established practices [1, 2]
We report a clinical case in a patient with typical chest Computed Tomography (CT) scan images with two negative real time Polymerase Chain Reaction (PCR) test
Summary
On 31 December 2019, China notified WHO about a cluster of pneumonia cases of unknown causes in Wuhan, Hubei province. We report a clinical case in a patient with typical chest CT scan images with two negative real time PCR test. The patient was a male, aged 66 years, weighing 82 kgs for a height of 187cm He lived 133 km from the city of Cotonou, where the highest number of cases of SARS-CoV-2 infection have been recorded in Benin. He had no known contact with anyone infected with SARS-CoV-2 and no cases had been identified in his city of residence at the time of his symptoms He initially presented with a productive cough, fever of 38.5°C, secondarily with shortness of breath on exertion, intense asthenia and palpitations. 150 Adjagba Philippe Mahouna et al.: Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not. Cardiovascular abnormalities: Left segmental embolism (red arrows). Readmitted to the emergency room for respiratory distress 7 days later, the patient died
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