Seibert Felix S, Toma Daniela, Bauer Frederic, Paniskaki Krystallenia, Anft Moritz, Rohn Benjamin J, Wang Simon, Racovitan Diana, Babel Nina, Westhoff Timm H
Medical Department 1, University Hospital Marien Hospital Herne, Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, Germany.
Center for Translational Medicine, University Hospital Marien Hospital Herne, Ruhr University Bochum, Herne, Germany.
J Med Case Rep. 2020 Dec 11;14(1):242. doi: 10.1186/s13256-020-02551-1.
Developing 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.
We 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.
Negative 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.
为新型冠状病毒肺炎（SARS-CoV-2感染）制定治疗策略具有挑战性，但首先必须做出正确诊断。非特异性的上、下呼吸道症状可能会产生误导；因此，实时逆转录聚合酶链反应的鼻咽拭子检测非常重要。然而，病毒早期清除会影响对COVID-19的准确诊断。
我们报告了两名白人患者，他们在新型冠状病毒肺炎发病初期咽拭子检测呈阴性。在一名患者中，尽管有典型的放射形态学改变，但在支气管肺泡灌洗中甚至检测不到病毒。
咽拭子和支气管肺泡灌洗的PCR检测结果为阴性并不能排除COVID-19肺炎。在这种情况下，计算机断层扫描是关键的诊断前提条件。
