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Updated: Aug 27, 2025

Lung CT Segmentation to Identify Consolidations and Ground Glass Areas for Quantitative Assesment of SARS-CoV Pneumonia
Published on: December 19, 2020
Infant with reverse-transcription polymerase chain reaction confirmed COVID-19 and normal chest computed tomography:
Guang-Hai Ji1, Bo Li1, Zu-Chuang Wu2
1Department of Radiology, The First Affiliated Hospital of Yangtze University, The First People's Hospital of Jingzhou, Jingzhou 434000, Hubei Province, China.
Insights
This case study highlights a 3-month-old infant with Coronavirus disease-2019 (COVID-19) presenting with diarrhea and normal chest imaging. Persistent positive RT-PCR results from anal swabs suggest potential fecal-oral transmission, offering insights for pediatric COVID-19 management.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Coronavirus disease-2019 (COVID-19) primarily affects adults, but pediatric cases are increasing.
- Infantile COVID-19 with normal chest computed tomography (CT) and non-respiratory symptoms is rarely reported.
- This study details a unique case of a 3-month-old infant diagnosed with COVID-19.
Observation:
- The infant presented with fever and diarrhea, initially with a normal chest CT scan.
- Reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 despite initial non-respiratory symptoms.
- Diarrhea persisted even after fever resolved, with positive nasopharyngeal and subsequent anal swab RT-PCR results.
Findings:
- The infant received systematic treatment and showed significant symptom improvement.
- Consecutive RT-PCR tests revealed negative pharyngeal swabs but positive anal swabs.
- The patient was discharged after 31 days of hospitalization.
Implications:
- This case provides valuable reference for managing infantile COVID-19 cases presenting with diarrhea or other non-respiratory symptoms and normal chest CT.
- The persistent positive RT-PCR results in anal swabs suggest the potential for fecal-oral transmission of COVID-19.
- Consideration of fecal-oral transmission is crucial for infection control and treatment strategies in pediatric COVID-19.
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 5th 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 31st 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.
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