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. 2020 Aug 10:202708. doi: 10.1148/radiol.2020202708

Figure 4:

False positive CO-RADS 5 in SARS-CoV-2 PCR-negative symptomatic individual. A, axial and, B, sagittal CT scan of symptomatic individual with CO-RADS 5 but negative SARS-CoV-2 PCR test. Clinical summary: a 49 year old woman with medical history of haemochromatosis and psoriatic arthritis was admitted with wheezing, dry cough and increasing dyspnea since 2 weeks. She was subfebrile and hypoxic (89% SpO2). Blood testing showed increased CRP (32.8 mg/L) and leukocytosis with eosinophilia (1.1 x 10e3/µl). CT showed no pleural effusion but presence of multifocal bilateral ground glass opacities, scored as CO-RADS 5. SARS-CoV-2 PCR was repeatedly negative on nasopharyngeal swab. Extended syndromic PCR testing for 33 respiratory pathogens including 14 respiratory viruses was negative. Bronchoalveolar lavage was also repeatedly negative for SARS-CoV-2 PCR but showed high load of eosinophils (52 % of 65 x 10e4 nucleated cells/mL) supporting the diagnosis of acute eosinophilic pneumonia. The woman was successfully treated with corticosteroids.

False positive CO-RADS 5 in SARS-CoV-2 PCR-negative symptomatic individual. A, axial and, B, sagittal CT scan of symptomatic individual with CO-RADS 5 but negative SARS-CoV-2 PCR test. Clinical summary: a 49 year old woman with medical history of haemochromatosis and psoriatic arthritis was admitted with wheezing, dry cough and increasing dyspnea since 2 weeks. She was subfebrile and hypoxic (89% SpO2). Blood testing showed increased CRP (32.8 mg/L) and leukocytosis with eosinophilia (1.1 x 10e3/µl). CT showed no pleural effusion but presence of multifocal bilateral ground glass opacities, scored as CO-RADS 5. SARS-CoV-2 PCR was repeatedly negative on nasopharyngeal swab. Extended syndromic PCR testing for 33 respiratory pathogens including 14 respiratory viruses was negative. Bronchoalveolar lavage was also repeatedly negative for SARS-CoV-2 PCR but showed high load of eosinophils (52 % of 65 x 10e4 nucleated cells/mL) supporting the diagnosis of acute eosinophilic pneumonia. The woman was successfully treated with corticosteroids.