Negative SARS-COV-2 pleural effusion in breast carcinoma coincide with COVID-19 infection: Case report

INTRODUCTION: and Importance: COVID-19 infection presents various symptoms that may resemble signs and symptoms of other underlying diseases. Pleural effusion in a confirmed COVID-19 patient with a history of malignancy is found to be rare, and the exact pathogenesis is still unclear. Hence RT-PCR COVID-19 assay from pleural effusion fluid is essential. CASE PRESENTATION: A 62-year-old female patient was admitted to the emergency department with a complaint of shortness of breath and headache. Previously, the patient was diagnosed with stage III breast carcinoma. The chest radiograph showed massive pleural effusion. The SARS-CoV-2 was found in the nasopharyngeal and oropharyngeal sample, but the RT-PCR COVID-19 assay of pleural fluid was negative. CLINICAL DISCUSSION: Pleural effusion can be an uncommon manifestation of COVID-19, but there are many other etiologies. Malignancy is a commonly encountered underlying cause of the pleural effusion. Since it presents similar respiratory signs and symptoms, awareness of possible etiologies is pivotal. A strict examination, assessment, and protocol should be done to prevent the intervention's potential hazard. CONCLUSION: Pleural effusion related to COVID-19 infection can resemble the clinical presentation in a patient with a malignancy history. SARS-CoV-2 can be found in the nasopharyngeal and oropharyngeal sample but absent in pleural effusion fluid.