Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is detectable in nasopharyngeal specimens for up to 12–20 days regardless of the presence of chronic diseases in patients. We report a case of prolonged SARS-CoV-2 infection that lasted for more than eight weeks. The patient had persistent lymphopenia after receiving six cycles of bendamustine and rituximab (BR) therapy for follicular lymphoma; the last chemotherapy session was completed nine months before admission. The first nasopharyngeal specimen (NPS) for the SARS-CoV-2 polymerase chain reaction assay tested positive for the N501Y variant five weeks before admission. The patient's general and respiratory conditions gradually worsened; therefore, he was admitted to our hospital, and the same SARS-CoV-2 variant was subsequently identified on admission. Treatment for coronavirus disease was initiated, and the patient's condition improved; however, the NPS tested positive on day 15. The patient was discharged on day 28 and was instructed to isolate at home for a month. Hence, possible prolonged SARS-CoV-2 shedding should be considered in patients who receive BR therapy.
Many studies have been conducted on ventilator-associated complications (VACs) in COVID-19 patients. However, in these studies, the causative organisms were similar, and there are no reports on VAC corresponding with Corynebacteria. Coryneforms are frequently cultured in polymicrobial infections and are usually considered contaminants in respiratory specimens. However today, Corynebacterium pseudodiphtheriticum or striatum is known to be a pathogen in lower respiratory tract infection. We report three cases of VAC probably due to Corynebacterium pseudodiphtheriticum in COVID-19 patients. If purulent lower respiratory specimens showed coryneform predominantly via Gram staining, empirical therapy should be started. Furthermore, species identification and drug susceptibility testing should be performed.
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