TY - JOUR
T1 - Usefulness of bronchoalveolar lavage in the management of patients presenting with lung infiltrates and suspect COVID-19-associated pneumonia
T2 - A case report
AU - Gualano, Gina
AU - Musso, Maria
AU - Mosti, Silvia
AU - Mencarini, Paola
AU - Mastrobattista, Annelisa
AU - Pareo, Carlo
AU - Zaccarelli, Mauro
AU - Migliorisi, Paolo
AU - Vittozzi, Pietro
AU - Zumla, Alimudin
AU - Ippolito, Giuseppe
AU - Palmieri, Fabrizio
PY - 2020/8
Y1 - 2020/8
N2 - Objective: To report a clinical case of a patient with a compatible HRCT scan and two negative SARS-CoV-2 RNA upper respiratory tract specimens but with a confirmed viral infection by BAL (19 days after symptom onset). Methods: Revision of a patient's clinical charts with COVID-19 admitted at INMI L. Spallanzani Hospital Results: Two oropharyngeal swab tests of SARS-CoV-2 by qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay were performed at admission (17 days from symptoms onset) and a day apart and were found negative. BAL fluid collected 19 days after symptoms onset was positive for SARS-CoV-2. Conclusion: This case highlights importance of clinical suspicion of SARS-CoV-2 infection in diagnosis and infectivity assessment. We suggest collection of BAL fluid when consecutive nasopharyngeal swabs are negative, to confirm or exclude the diagnosis of COVID-19-associated pneumonia. Healthcare workers should perform aerosol-generating procedures in an adequately ventilated room and should wear adequate PPE.
AB - Objective: To report a clinical case of a patient with a compatible HRCT scan and two negative SARS-CoV-2 RNA upper respiratory tract specimens but with a confirmed viral infection by BAL (19 days after symptom onset). Methods: Revision of a patient's clinical charts with COVID-19 admitted at INMI L. Spallanzani Hospital Results: Two oropharyngeal swab tests of SARS-CoV-2 by qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay were performed at admission (17 days from symptoms onset) and a day apart and were found negative. BAL fluid collected 19 days after symptoms onset was positive for SARS-CoV-2. Conclusion: This case highlights importance of clinical suspicion of SARS-CoV-2 infection in diagnosis and infectivity assessment. We suggest collection of BAL fluid when consecutive nasopharyngeal swabs are negative, to confirm or exclude the diagnosis of COVID-19-associated pneumonia. Healthcare workers should perform aerosol-generating procedures in an adequately ventilated room and should wear adequate PPE.
KW - BAL fluid
KW - COVID-19
KW - Nasopharyngeal swabs
KW - SARS CoV2 pneumonia
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U2 - 10.1016/j.ijid.2020.05.027
DO - 10.1016/j.ijid.2020.05.027
M3 - Article
C2 - 32437932
AN - SCOPUS:85086649018
VL - 97
SP - 174
EP - 176
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -