ABSTRACT
Many studies have been conducted on ventilator-associated complications (VACs) in patients with coronavirus 2019 (COVID-19). However, in these studies, the causative organisms were similar, and there were no reports on VAC corresponding with Corynebacteria. Coryneforms are frequently cultured in cases of polymicrobial infections and are usually considered contaminants in respiratory specimens. However, Corynebacterium pseudodiphtheriticum or C. striatum is known to be a pathogen in lower respiratory tract infections. We report three cases of VAC, probably due to C. pseudodiphtheriticum, in patients with COVID-19. If purulent lower respiratory tract specimens showed coryneform predominantly upon Gram staining, empirical therapy should be started. Furthermore, species identification and drug susceptibility testing should be performed.
Subject(s)
COVID-19 , Coinfection , Corynebacterium Infections , Mycobacterium tuberculosis , Coinfection/complications , Corynebacterium , Corynebacterium Infections/complications , Corynebacterium Infections/diagnosis , Humans , Microbial Sensitivity Tests , Respiration, Artificial/adverse effectsSubject(s)
Anticoagulants/adverse effects , Antithrombins/therapeutic use , Blood Coagulation/drug effects , Coronavirus Infections/therapy , Heparin/adverse effects , Pipecolic Acids/therapeutic use , Pneumonia, Viral/therapy , Pulmonary Embolism/drug therapy , Thrombocytopenia/drug therapy , Adult , Anticoagulants/administration & dosage , Arginine/analogs & derivatives , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/virology , Heparin/administration & dosage , Host-Pathogen Interactions , Humans , Male , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Pulmonary Embolism/blood , Pulmonary Embolism/diagnosis , Pulmonary Embolism/virology , SARS-CoV-2 , Sulfonamides , Thrombocytopenia/blood , Thrombocytopenia/chemically induced , Thrombocytopenia/diagnosis , Treatment OutcomeABSTRACT
The patient, an 83-year-old woman, lived with her daughter, at whose workplace, a person had been diagnosed as having COVID-19. The daughter was admitted to the hospital for pneumonia, however, the results of the PCR test for SARS-CoV-2 performed twice were negative. The patient developed fever a few days later, and visited an outpatient clinic for patients with fever and a history of travel abroad. The result of a nasal swab PCR test was negative, and antibiotics were prescribed. While the fever gradually subsided, the patient began to experience dyspnea. Therefore, she visited the outpatient clinic again for a repeat nasal swab test. Meanwhile, the dyspnea became severe and she was transported to our hospital. Immediately after admission, she was intubated and initiated on mechanical ventilation. A nasal swab and a specimen of lower respiratory tract secretions were submitted for COVID-19 testing by PCR, and while the nasal swab test result was negative again, the lower respiratory tract specimen yielded a positive result�E�EThe possibility of false-negative results of PCR testing for SARS-CoV-2 should be borne in mind in close contacts or strongly suspected cases of COVID-19. PCR testing of specimens of lower respiratory tract secretions might be necessary for suspected cases of COVID-19 pneumonia.