Öz Miraç, Gürün Kaya Aslıhan, Velioğlu Yakut Övgü, Gülten Ezgi, Talan Leyla, Erol Serhat, Çiftci Fatma, Uzun Çağlar, Karahan Zeynep Ceren, Altıntaş Neriman Defne, Çiledağ Aydın, Kaya Akın
Department of Chest Diseases, Ankara University Faculty of Medicine, Ankara, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey.
Tuberk Toraks. 2020 Dec;68(4):444-448. doi: 10.5578/tt.70357.
Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of emerging atypical pneumonia. In patients with tracheostomy, coronavirus hypothetically coexists with well-known bacterial agents. A 61-year-old male patient with tracheostomy was admitted to the hospital with dyspnea, fever and increased tracheal secretions. Laboratory findings revealed lymphopenia and elevated C-reactive protein and procalcitonin levels. Chest computed tomography showed consolidation areas and ground-glass opacities more prominent in subpleural areas. Although; two consecutive RT-PCR analyses of combined nasopharengeal/oropharengeal swabs were found to be negative for SARS-CoV-2 RNA, positivity was reported for endotracheal aspirate (ETA) sample. Significant growth of Pseudomonas aeruginosa and Stenotrophomonas maltophilia was detected in the bacterial culture of ETA sample. In conclusion, clinical samples for SARS-CoV-2 should be obtained through the lower respiratory tract, if possible and if upper airway samples are negative. To the best our knowledge, our paper is the first report of the patient with tracheostomy who was treated successfully for COVID-19.
2019冠状病毒病（COVID-19）已被证实是新型非典型肺炎的病因。对于气管切开术患者，冠状病毒可能与常见细菌病原体共存。一名61岁的气管切开术男性患者因呼吸困难、发热和气管分泌物增多入院。实验室检查结果显示淋巴细胞减少，C反应蛋白和降钙素原水平升高。胸部计算机断层扫描显示胸膜下区域的实变区和磨玻璃影更为明显。尽管对鼻咽/口咽联合拭子进行的连续两次逆转录聚合酶链反应（RT-PCR）分析均未检测到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA，但气管内吸出物（ETA）样本检测呈阳性。在ETA样本的细菌培养中检测到铜绿假单胞菌和嗜麦芽窄食单胞菌大量生长。总之，如果可能且上呼吸道样本为阴性，应通过下呼吸道获取SARS-CoV-2的临床样本。据我们所知，我们的论文是首例成功治疗COVID-19的气管切开术患者的报告。
