A 33-year-old Chinese woman visited our hospital complaining of fever, cough and fatigue for 2 days. She resided in Wuhan city, and travelled to Guangzhou city 10 days ago. The woman was previously healthy with no past medical history. Physical examination was normal apart from low-grade fever. Blood tests showed normal lymphocyte cell of 1.5×10⁹/L, but slightly decreased white blood cell of 3.21×10⁹/L and neutrophil cell of 1.5×10⁹/L. C-reactive protein, sedimentation rate, procalcitonin, liver function, creatinase, influenza A and B viruses antigens were normal.
Her chest CT showed ill-defined ground-glass opacity (GGO) and crazy-paving pattern in the right lower lung periphery (figure). Although throat swab was initial negative for 2019 novel coronavirus (SARS-CoV-2) on real-time reverse-transcription-polymerase-chain reaction (RT-PCR), reexamination was positive after 2 days. The diagnosis of SARS-CoV-2 pneumonia was made.
The patient was isolated, and treated with ribavirin and supportive therapies with complete recovery after 2 weeks.
Since December 2019, an outbreak of SARS-CoV-2 disease (COIVD-19) has been first reported in Wuhan, Hubei province, China, and has spread to all over China and multiple countries. Positive real-time RT-PCR result is the gold standard for diagnosing COIVD-19. However, a growing number of patients with typical CT findings (such as GGO and crazy-paving pattern) were reported with a negative initial real-time RT-PCR result but positive in the repeated tests (one or more times). The epidemiological history, clinical characteristics and feature of GGO on CT are crucial for early diagnosis during the outbreak of COIVD-19.
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