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在鼻咽样本中未检测到 SARS-CoV-2,但在支气管肺泡灌洗液中检测到。

SARS-CoV-2 not Detected in the Nasopharyngeal Sample but in Bronchoalveolar Lavage Fluid.

出版信息

Clin Lab. 2024 Sep 1;70(9). doi: 10.7754/Clin.Lab.2024.240404.

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection typically relies on reverse transcription-polymerase chain reaction (RT-PCR) technology. However, there is a certain rate of missed detection of SARS-CoV-2 in nasopharyngeal samples, particularly among immunosuppressed individuals.

METHODS

In this case, SARS-CoV-2 was detected in nasopharyngeal swabs and bronchoalveolar lavage fluid (BALF) using RT-PCR. Pulmonary imaging was performed using computed tomography (CT). Patient clinical data were retrieved from the Laboratory Information System (LIS).

RESULTS

SARS-CoV-2 was negative in two nasopharyngeal tests of the patient, but was finally detected in BALF, confirming that the lung lesions were infected by SARS-CoV-2.

CONCLUSIONS

In the post-epidemic era, it is necessary to use BALF to identify SARS-CoV-2 infection in cases where other factors have been ruled out in immunosuppressed individuals with pulmonary infections, especially when the nasopharyngeal test yields a negative result.

摘要

背景

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的检测通常依赖于逆转录-聚合酶链反应(RT-PCR)技术。然而,在鼻咽样本中,SARS-CoV-2 的检测存在一定的漏检率,尤其是在免疫抑制个体中。

方法

本案例中,使用 RT-PCR 检测鼻咽拭子和支气管肺泡灌洗液(BALF)中的 SARS-CoV-2。采用计算机断层扫描(CT)进行肺部影像学检查。患者的临床数据从实验室信息系统(LIS)中提取。

结果

患者的两次鼻咽拭子检测 SARS-CoV-2 均为阴性,但最终在 BALF 中检测到,证实肺部病变感染了 SARS-CoV-2。

结论

在后疫情时代,对于免疫抑制的肺部感染患者,在排除其他因素后,若鼻咽拭子检测结果为阴性,需要使用 BALF 来识别 SARS-CoV-2 感染,尤其是在鼻咽拭子检测结果为阴性时。

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