Felix S Seibert1, Daniela Toma2, Frederic Bauer2, Krystallenia Paniskaki3, Moritz Anft3, Benjamin J Rohn2, Simon Wang2, Diana Racovitan2, Nina Babel2,3, Timm H Westhoff2. 1. Medical Department 1, University Hospital Marien Hospital Herne, Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, Germany. seibertfelix@gmail.com. 2. Medical Department 1, University Hospital Marien Hospital Herne, Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, Germany. 3. Center for Translational Medicine, University Hospital Marien Hospital Herne, Ruhr University Bochum, Herne, Germany.
Abstract
BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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.
BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSIONS: 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.