Abstract
BackgroundDeveloping therapeutic strategies for a SARS-CoV-2 infection is challenging, but first the correct diagnosis has to be made. Unspecific upper and lower respiratory tract symptoms can be misleading; hence, a nasopharyngeal swab test with a real-time reverse-transcription-polymerase chain reaction is of great importance. However, early viral clearing jeopardizes a sound diagnosis of COVID-19.Case presentationWe report on two Caucasian patients who had negative pharyngeal swab tests at the onset of SARS-CoV-2 pneumonia. In one patient, the virus was not even detectable in bronchoalveolar lavage despite typical radiomorphologic changes.ConclusionsNegative PCR findings in both the pharynx and bronchoalveolar lavage do not exclude COVID-19 pneumonia. Computed tomography is a crucial diagnostic prerequisite in this context.
Highlights
Developing therapeutic strategies for a SARS-CoV-2 infection is challenging, but first the correct diagnosis has to be made
Computed tomography showed bilateral ground-glass opacities (Fig. 1b), and a bronchoalveolar lavage (BAL) was obtained. Both the final pharyngeal swab test and the BAL fluid were negative for 2019 novel coronavirus
We present two cases of COVID-19 pneumonia, which emphasize the aspect of time-dependent SARS-CoV-2 diagnostics
Summary
Developing therapeutic strategies for a SARS-CoV-2 infection is challenging, but first the correct diagnosis has to be made. Conclusions: Negative PCR findings in both the pharynx and bronchoalveolar lavage do not exclude COVID-19 pneumonia. We present two cases of COVID-19 pneumonia in subjects with negative PCR tests. These cases should alert physicians that negative PCR findings do not rule out the disease in subjects with pneumonia. Two days prior to admission, she was given an oropharyngeal and nasopharyngeal swab test by her general physician, which was negative for SARS-CoV-2.
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