Infant with reverse-transcription polymerase chain reaction confirmed COVID-19 and normal chest computed tomography: A case report

Abstract

BACKGROUND

Coronavirus disease-2019 (COVID-19) is a highly pathogenic respiratory disease that mainly affects adults and elderly patients. Yet, over the past three years, there were an increasing number of infected children; however, only a few cases of infants with reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 and chest computed tomography (CT) normal have been reported. Herein, we reported a single case of a patient (a 3-mo-old girl) with COVID-19, including her clinical and imaging findings.

CASE SUMMARY

The patient with fever, diarrhea came to fever clinic. Her chest CT was normal. The patient was treated accordingly, the fever disappeared while diarrhea persisted, what’s more, RT-PCR testing of nasopharyngeal swab showed positive results; thus, the patient was admitted to the pediatric department on the 5^th day of onset. The child was given systematic treatment, and all her symptoms significantly improved. Consecutive RT-PCR tests were negative after examining the pharyngeal swabs but positive after analyzing anal swabs. She was discharged on the 31^st day of hospitalization.

CONCLUSION

This report provides useful references for treating infantile COVID-19 cases with diarrhea or other non-respiratory symptoms and normal chest CT scan. Given the persistent positive RT-PCR results of anal swabs, the possibility of fecal-oral transmission of COVID-19 should be considered.

Keywords: Infant; COVID-19; SARS-CoV-2; Tomography; Case report

Core Tip: This study reports an atypical infantile case of coronavirus disease-2019 accompanied by diarrhea or other non-respiratory symptoms. We presented the medical history and the whole process of diagnosis and management of the case and did a literature review. In this paper, we share our experience, which might provide a useful reference for pediatricians and radiologists.