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从一名 COVID-19 肺炎 CT 典型表现患者的粪便样本中检测到 SARS-CoV-2,但多次咽拭子和鼻拭子 SARS-CoV-2 RT-PCR 检测均为阴性。

SARS-CoV-2 Detection in Fecal Sample from a Patient with Typical Findings of COVID-19 Pneumonia on CT but Negative to Multiple SARS-CoV-2 RT-PCR Tests on Oropharyngeal and Nasopharyngeal Swab Samples.

机构信息

Department of Radiology, Moscati Hospital, Contrada Amoretta, 83100 Avellino, Italy.

Specialist-Craniomed Laboratory Group srl, Viale degli Astronauti, 45, 83038 Montemiletto, Italy.

出版信息

Medicina (Kaunas). 2021 Mar 20;57(3):290. doi: 10.3390/medicina57030290.

Abstract

Reverse transcriptase polymerase chain reaction (RT-PCR) negative results in the upper respiratory tract represent a major concern for the clinical management of coronavirus disease 2019 (COVID-19) patients. Herein, we report the case of a 43-years-old man with a strong clinical suspicion of COVID-19, who resulted in being negative to multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR tests performed on different oropharyngeal and nasopharyngeal swabs, despite serology having confirmed the presence of SARS-CoV-2 IgM. The patient underwent a chest computed tomography (CT) that showed typical imaging findings of COVID-19 pneumonia. The presence of viral SARS-CoV-2 was confirmed only by performing a SARS-CoV-2 RT-PCR test on stool. Performing of SARS-CoV-2 RT-PCR test on fecal samples can be a rapid and useful approach to confirm COVID-19 diagnosis in cases where there is an apparent discrepancy between COVID-19 clinical symptoms coupled with chest CT and SARS-CoV-2 RT-PCR tests' results on samples from the upper respiratory tract.

摘要

逆转录聚合酶链反应(RT-PCR)检测上呼吸道结果为阴性,这是 2019 年冠状病毒病(COVID-19)患者临床管理的主要关注点。在此,我们报告了一例 43 岁男性的病例,该患者临床高度疑似 COVID-19,但多次对不同的咽拭子和鼻咽拭子进行严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)RT-PCR 检测结果均为阴性,尽管血清学检测证实存在 SARS-CoV-2 IgM。该患者进行了胸部计算机断层扫描(CT),显示出 COVID-19 肺炎的典型影像学表现。仅通过对粪便进行 SARS-CoV-2 RT-PCR 检测才确认存在病毒 SARS-CoV-2。对于 COVID-19 临床症状、胸部 CT 与上呼吸道样本 SARS-CoV-2 RT-PCR 检测结果之间明显不一致的情况下,对粪便样本进行 SARS-CoV-2 RT-PCR 检测可快速、有效地确诊 COVID-19。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fbf/8003654/34cf00000d47/medicina-57-00290-g001.jpg

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