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

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.