Delayed Diagnosis and Treatment of a Critically Ill Patient with Infective Endocarditis Due to a False-Positive Molecular Diagnostic Test for SARS-CoV-2

Schizas, Nikolaos; Michailidis, Theodoros; Samiotis, Ilias; Patris, Vasilios; Papakonstantinou, Konstantinos; Argiriou, Michail; Dedeilias, Panagiotis

Patient: Male, 53-year-old Final Diagnosis: Infective endocarditis Symptoms: Dynpnea • fever Medication:— Clinical Procedure: Surgical aortic valve replacement Specialty: Cardiac surgery OBJECTIVE: Challenging differential diagnosis BACKGROUND: The worldwide spread of the severe acute respiratory syndrome-coronavirus-2 (SARS-COV-2) has created unprecedented situations for healthcare professionals and healthcare systems. Although infection with this virus is considered the main health problem currently, other diseases are still prevalent. CASE REPORT: This report describes a 59-year-old man who presented with symptoms of dyspnea and fever that were attributed to Covid-19 infection. His clinical condition deteriorated and further examinations revealed a subjacent severe aortic regurgitation due to acute infective endocarditis. Surgical treatment was successful. CONCLUSIONS: The results of diagnostic tests for Covid-19 should be re-evaluated whenever there are clinical mismatches or doubts, as false-positive Covid-19 test results can occur. Clinical interpretation should not be determined exclusively by the Covid-19 pandemic. This case report highlights the importance of using validated and approved serological and molecular testing to detect infection with SARS-CoV-2, and to repeat tests when there is doubt about presenting symptoms.