Detection of SARS-CoV-2 pneumonia: A Case Report
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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.

A 60-year-old female patient was admitted to the hospital in March 2020 for suspected pneumonia. She had a history of hypertension and was otherwise healthy. Her oral medication contained an angiotensin receptor blocker (candesartan cilexetil 8 mg twice daily). She had no history of smoking but did occasionally consume alcohol. She was working as a secretary in a company specialized in the processed food supply. She had lived for the last 17 years with her husband in an urban area in the vicinity of our hospital. She reported fever, shivers, and cough for 7 days and a change in her sense of taste. The probable time of infection was 8 days prior to the onset of symptoms when she was in an airport in Austria with many people who were leaving the area after ski vacations.

Two days prior to admission, she was given an oropharyngeal and nasopharyngeal swab test by her general physician, which was negative for SARS-CoV-2. The swab test was repeated in our hospital after her admission with a confirmation of the negative result. RT-PCR was conducted according to the TIB MOLBIOL cycling parameters on a Roche LightCycler 480. At this time, her body temperature was 37.4 °C, blood pressure 128/78 mmHg and heart frequency 61 beats per minute. The physical and neurologic examination was unremarkable, except for her taste loss. Computed tomography showed ground-glass opacities with the beginning of consolidation. Bronchoscopy was performed to obtain bronchoalveolar lavage (BAL) fluid, which finally tested positive for SARS-CoV-2. She was provided with subcutaneous antithrombotic prophylaxis (enoxaparin 40 mg once daily). Aerobic and anaerobic blood cultures remained sterile, and no fungi were detected.

Source:https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-020-02551-1
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