Preprint Case Report Version 1 This version is not peer-reviewed

COVID-19 with Positive Bronchoalveolar Lavage Fluid (BALF) But Negative Nasopharyngeal and Oropharyngeal Swabs: Case Report and Insights

Version 1 : Received: 4 June 2020 / Approved: 9 June 2020 / Online: 9 June 2020 (03:30:05 CEST)

How to cite: Jahromi, R.; Avazpour, A.; Jahromi, M.; Alavi, J. COVID-19 with Positive Bronchoalveolar Lavage Fluid (BALF) But Negative Nasopharyngeal and Oropharyngeal Swabs: Case Report and Insights. Preprints 2020, 2020060113 (doi: 10.20944/preprints202006.0113.v1). Jahromi, R.; Avazpour, A.; Jahromi, M.; Alavi, J. COVID-19 with Positive Bronchoalveolar Lavage Fluid (BALF) But Negative Nasopharyngeal and Oropharyngeal Swabs: Case Report and Insights. Preprints 2020, 2020060113 (doi: 10.20944/preprints202006.0113.v1).

Abstract

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mainly affects the respiratory system with some patients rapidly progressing to acute respiratory distress syndrome (ARDS). The most common symptoms of the patients are fever, cough, dyspnea, myalgia, and fatigue. 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 young case of COVID-19, without any pre-existing medical conditions, whose both nasopharyngeal and oropharyngeal swab tests of SARS-CoV-2 were negative in the prodromal phase. However, after three days, with severe dyspnea and rapidly progressed acute respiratory distress syndrome (ARDS), the case was identified as infected by COVID-19 by testing bronchoalveolar lavage fluid (BALF). The patient was intubated in the intensive care unit (ICU) but expired on the fourth day. This case shows the importance of active and accurate monitoring of the patients showing COVID-19 symptoms. Although the BALF test has a higher exposure risk, it is considered more accurate and recommended if performed by an expert operator.

Subject Areas

COVID-19; SARS-CoV-2; ARDS; bronchoalveolar lavage fluid (BALF)

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