COVID-19 WITH POSITIVE BRONCHOALVEOLAR LAVAGE FLUID BUT NEGATIVE NASOPHARYNGEAL AND OROPHARYNGEAL SWABS: A CASE REPORT AND INSIGHTS

Reza Jahromi, Arezoo Avazpour, Maryam Jahromi, Jalile Alavi
2020 Indian Journal of Case Reports  
Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system, with some patients rapidly progressing to acute respiratory distress syndrome (ARDS). Nasopharyngeal and oropharyngeal swab specimens tested by real-time reverse transcription-polymerase chain reaction (RT-PCR) are the most commonly used methods to diagnose COVID-19. Herein, we investigate and discuss a 33-year-old case of COVID-19, without any preexisting medical conditions, whose both nasopharyngeal and oropharyngeal
more » ... and oropharyngeal swabs were negative in the prodromal phase despite showing COVID-19 symptoms. However, after 3 days, with severe dyspnea and rapidly progressed ARDS, the patient was identified as infected by COVID-19 by testing bronchoalveolar lavage fluid (BALF). He was intubated in the intensive care unit (ICU) but expired on the 4 th day. This case shows the importance of active and accurate monitoring of the patients showing COVID-19 symptoms. If nasopharyngeal and oropharyngeal swabs are negative, a BALF test is recommended if performed by an expert operator.
doi:10.32677/ijcr.2020.v06.i07.010 fatcat:rznwxoiu5rahpnrnw3p7j7jrjq