American Journal of Internal Medicine

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Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not

Received: 12 May 2020    Accepted: 28 May 2020    Published: 04 June 2020
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Abstract

Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. He had no known contact with infected persons. He initially presented with a productive cough, fever, shortness of breath on exertion, intense asthenia and palpitations. The real time PCR with upper airway samples was conducted on days 18 and 20 of the onset of symptoms and was negative. Despite chest CT abnormalities, the patient was not considered to be infected SARS-CoV-2 according to national recommendations for diagnosis and treatment in Benin. He was discharged from the treatment centre. Readmitted 7 days later to the emergency room for respiratory distress, the patient died. Conclusion. Diagnosis of SARS-CoV-2 infection can be difficult. In the context of typical clinical presentation, chest CT features of viral pneumonia may be strongly suspicious for SARS-CoV-2 despite negative real time PCR results. In order to improve the diagnostic and therapeutic strategy for SARS-CoV-2 infection in Benin, chest CT and other diagnostic tests/ criteria should be adopted.

DOI 10.11648/j.ajim.20200804.12
Published in American Journal of Internal Medicine (Volume 8, Issue 4, July 2020)
Page(s) 148-152
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

SARS-CoV-2, Real Time PCR, False Negative, Chest CT

References
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Author Information
  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Imaging and Radiodiagnostic, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CHUDBA, University of Parakou, Parakou, Benin

  • Radiography, Ultrasound and Scanning Centre, Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Microbiology and Parasitology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Imaging and Radiodiagnostic, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Imaging and Radiodiagnostic, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

  • University Clinic of Cardiology, CNHU-HKM, University of Abomey-Calavi (UAC), Cotonou, Benin

Cite This Article
  • APA Style

    Adjagba Philippe Mahouna, Adjadohoun Sonia, Hounkponou Murielle, Sonou Arnaud, Codjo Léopold, et al. (2020). Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not. American Journal of Internal Medicine, 8(4), 148-152. https://doi.org/10.11648/j.ajim.20200804.12

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    ACS Style

    Adjagba Philippe Mahouna; Adjadohoun Sonia; Hounkponou Murielle; Sonou Arnaud; Codjo Léopold, et al. Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not. Am. J. Intern. Med. 2020, 8(4), 148-152. doi: 10.11648/j.ajim.20200804.12

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    AMA Style

    Adjagba Philippe Mahouna, Adjadohoun Sonia, Hounkponou Murielle, Sonou Arnaud, Codjo Léopold, et al. Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not. Am J Intern Med. 2020;8(4):148-152. doi: 10.11648/j.ajim.20200804.12

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  • @article{10.11648/j.ajim.20200804.12,
      author = {Adjagba Philippe Mahouna and Adjadohoun Sonia and Hounkponou Murielle and Sonou Arnaud and Codjo Léopold and Soho Edson and Dahito Mickaella and Avocèvou Géraud and Djoh Ingrid and Sissinto Yolande and Yèkpè Patricia and Biaou Olivier and Houenassi Dèdonougbo Martin},
      title = {Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not},
      journal = {American Journal of Internal Medicine},
      volume = {8},
      number = {4},
      pages = {148-152},
      doi = {10.11648/j.ajim.20200804.12},
      url = {https://doi.org/10.11648/j.ajim.20200804.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20200804.12},
      abstract = {Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. He had no known contact with infected persons. He initially presented with a productive cough, fever, shortness of breath on exertion, intense asthenia and palpitations. The real time PCR with upper airway samples was conducted on days 18 and 20 of the onset of symptoms and was negative. Despite chest CT abnormalities, the patient was not considered to be infected SARS-CoV-2 according to national recommendations for diagnosis and treatment in Benin. He was discharged from the treatment centre. Readmitted 7 days later to the emergency room for respiratory distress, the patient died. Conclusion. Diagnosis of SARS-CoV-2 infection can be difficult. In the context of typical clinical presentation, chest CT features of viral pneumonia may be strongly suspicious for SARS-CoV-2 despite negative real time PCR results. In order to improve the diagnostic and therapeutic strategy for SARS-CoV-2 infection in Benin, chest CT and other diagnostic tests/ criteria should be adopted.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Clinical Case with Negative Polymerase Chain Reaction (PCR) and Suspicious Chest Computed Tomography (CT) Images SARS-CoV-2 Infection or Not
    AU  - Adjagba Philippe Mahouna
    AU  - Adjadohoun Sonia
    AU  - Hounkponou Murielle
    AU  - Sonou Arnaud
    AU  - Codjo Léopold
    AU  - Soho Edson
    AU  - Dahito Mickaella
    AU  - Avocèvou Géraud
    AU  - Djoh Ingrid
    AU  - Sissinto Yolande
    AU  - Yèkpè Patricia
    AU  - Biaou Olivier
    AU  - Houenassi Dèdonougbo Martin
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    DO  - 10.11648/j.ajim.20200804.12
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    EP  - 152
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20200804.12
    AB  - Background: The SARS-CoV-2 infection has polymorphic clinical presentations. The real time PCR is the reference diagnostic test; however, it can only detect presence of virus for a specific window of time. Case: We report a clinical case in a patient aged 66 years. His clinical history included known hypertension for 10 years and ischemic stroke. He had no known contact with infected persons. He initially presented with a productive cough, fever, shortness of breath on exertion, intense asthenia and palpitations. The real time PCR with upper airway samples was conducted on days 18 and 20 of the onset of symptoms and was negative. Despite chest CT abnormalities, the patient was not considered to be infected SARS-CoV-2 according to national recommendations for diagnosis and treatment in Benin. He was discharged from the treatment centre. Readmitted 7 days later to the emergency room for respiratory distress, the patient died. Conclusion. Diagnosis of SARS-CoV-2 infection can be difficult. In the context of typical clinical presentation, chest CT features of viral pneumonia may be strongly suspicious for SARS-CoV-2 despite negative real time PCR results. In order to improve the diagnostic and therapeutic strategy for SARS-CoV-2 infection in Benin, chest CT and other diagnostic tests/ criteria should be adopted.
    VL  - 8
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