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Case Reports
. 2020 Aug:97:174-176.
doi: 10.1016/j.ijid.2020.05.027. Epub 2020 May 11.

Usefulness of bronchoalveolar lavage in the management of patients presenting with lung infiltrates and suspect COVID-19-associated pneumonia: A case report

Gina Gualano  1 , Maria Musso  2 , Silvia Mosti  3 , Paola Mencarini  4 , Annelisa Mastrobattista  5 , Carlo Pareo  6 , Mauro Zaccarelli  7 , Paolo Migliorisi  8 , Pietro Vittozzi  9 , Alimudin Zumla  10 , Giuseppe Ippolito  11 , Fabrizio Palmieri  12
Affiliations
Case Reports

Usefulness of bronchoalveolar lavage in the management of patients presenting with lung infiltrates and suspect COVID-19-associated pneumonia: A case report

Gina Gualano et al. Int J Infect Dis. 2020 Aug.

Abstract

Objective: To report a clinical case of a patient with a compatible HRCT scan and two negative SARS-CoV-2 RNA upper respiratory tract specimens but with a confirmed viral infection by BAL (19 days after symptom onset).

Methods: Revision of a patient's clinical charts with COVID-19 admitted at INMI L. Spallanzani Hospital RESULTS: Two oropharyngeal swab tests of SARS-CoV-2 by qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay were performed at admission (17 days from symptoms onset) and a day apart and were found negative. BAL fluid collected 19 days after symptoms onset was positive for SARS-CoV-2.

Conclusion: This case highlights importance of clinical suspicion of SARS-CoV-2 infection in diagnosis and infectivity assessment. We suggest collection of BAL fluid when consecutive nasopharyngeal swabs are negative, to confirm or exclude the diagnosis of COVID-19-associated pneumonia. Healthcare workers should perform aerosol-generating procedures in an adequately ventilated room and should wear adequate PPE.

Keywords: BAL fluid; COVID-19; Nasopharyngeal swabs; SARS CoV2 pneumonia.

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Figures

Fig. 1
Fig. 1
Chest CT images showing bilateral ground glass opacities.
See this image and copyright information in PMC

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