Do we trust the polymerase chain reaction test result in children to diagnose COVID-19? A case report of COVID-19

Abstract

BACKGROUND: Coronavirus disease-19 (COVID-19) resulted in widespread concern in global public health and has a bad prognosis despite drug therapy. CASE REPORT: The patient was an 11-year-old girl referred to a children hospital with a dry cough, fever, and headache symptoms, without comorbidity. She was hospitalized following the results of high-resolution computed tomography (HRCT). The patient was treated with ceftriaxone 1 g every 12 h and the oseltamivir capsule 45 mg every 12 h and azithromycin 250 mg tablet once daily and 200 mg hydroxychloroquine tablet every 12 h for a total of 5 days. After 5 days, the patient had suitable chest status and then was discharged. Azithromycin for 5 days and hydroxychloroquine for 10 days were prescribed for the patient to take at home. The patient’s polymerase chain reaction (PCR) was negative at baseline through the nasopharyngeal swap, but HRCT of the patient’s was completely consistent with COVID-19 accompanied by consolidation and ground-glass opacity in the left lower and right upper lobes. CONCLUSION: The numerous technical errors in taking the nasopharyngeal swap were the main reasons for the negative PCR. The main lesson from this case report is the high sensitivity and specificity of HRCT compared to the PCR.