Maeda Yoshitaka, Miyo Hiroyuki, Ohashi Atsuki, Yamamoto Takanobu, Ogata Tomoyuki
Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Toride, Ibaraki 302-0022, Japan.
Infection Control Team, Department of Internal Medicine, JA Toride Medical Center, Toride, Ibaraki 302-0022, Japan.
J Med Cases. 2020 Oct;11(10):330-335. doi: 10.14740/jmc3566. Epub 2020 Aug 28.
In a 75-year-old hemodialysis patient, pneumonia manifested with computed tomography (CT) images suggestive of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) was not detected with repeated polymerase chain reaction (PCR) tests, but serum immunoglobulin G (IgG) and IgM antibodies against SARS-CoV-2 turned positive with two different assay kits. The patient was thus treated as a probable COVID-19 case, and then recovered through the intensive care including ciclesonide, favipiravir, and methyl prednisolone. In PCR-negative cases, the diagnosis of COVID-19 cannot be established at present, but such COVID-19 cases certainly exist. To avoid a delay in treatment of COVID-19, available diagnostic tools should be utilized with careful attention for their limitations.
在一名75岁的血液透析患者中，肺炎通过计算机断层扫描（CT）图像表现出来，提示为2019冠状病毒病（COVID-19）。重复的聚合酶链反应（PCR）检测未检测到严重急性呼吸综合征冠状病毒2（SARS-CoV-2）核糖核酸（RNA），但使用两种不同的检测试剂盒检测，针对SARS-CoV-2的血清免疫球蛋白G（IgG）和IgM抗体呈阳性。因此，该患者被作为可能的COVID-19病例进行治疗，随后通过包括环索奈德、法匹拉韦和甲泼尼龙在内的重症监护治疗得以康复。在PCR检测呈阴性的病例中，目前尚不能确诊COVID-19，但这类COVID-19病例肯定存在。为避免延误COVID-19的治疗，应谨慎使用现有诊断工具，并充分注意其局限性。
