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Published on: December 19, 2020
The coronavirus diseases 2019 (COVID-19) pneumonia with spontaneous pneumothorax: a case report
Xiaoxing Chen1, Guqin Zhang2, Yueting Tang3
1Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China.
Insights
This case study describes a COVID-19 patient who developed spontaneous pneumothorax late in recovery. Early CT diagnosis and thoracic drainage were crucial for managing this rare complication.
Area of Science:
- Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- The global outbreak of coronavirus disease 2019 (COVID-19) has led to widespread pulmonary complications.
- Spontaneous pneumothorax as a complication of COVID-19 pneumonia remains poorly understood.
Observation:
- A 66-year-old male with COVID-19 pneumonia presented with fever, cough, and myalgia, initially responding to supportive and antiviral treatments.
- On hospital day 30, the patient developed sudden chest pain and dyspnea, with CT revealing a significant left-sided pneumothorax.
- Immediate thoracic closed drainage led to rapid improvement of respiratory distress.
Findings:
- The patient recovered from COVID-19, with negative PCR tests, but later developed spontaneous pneumothorax.
- Computed tomography (CT) imaging was essential for diagnosing the pneumothorax.
- Thoracic closed drainage effectively treated the spontaneous pneumothorax.
Implications:
- Clinicians should consider spontaneous pneumothorax in COVID-19 patients, particularly those with prolonged severe lung damage.
- Prompt CT imaging and effective intervention are vital for managing pneumothorax in this patient population.
- This case underscores the potential for delayed respiratory complications in severe COVID-19 cases.
Background:
The outbreak of the novel coronavirus (COVID-19) that was firstly reported in Wuhan, China, with cases now confirmed in more than 100 countries. However, COVID-19 pneumonia with spontaneous pneumothorax is unknown.
Case Presentation:
We reported a case of 66-year-old man infected with COVID-19, presenting with fever, cough and myalgia; The patient received supportive and empirical treatment including antiviral treatment, anti-inflammatory treatment, oxygen supply and inhalation therapy; The symptoms, CT images, laboratory results got improved after the treatments, and a throat swab was negative for COVID-19 PCR test; However, on the hospital day 30, the patient presented with a sudden chest pain and dyspnea. CT showed a 30-40% left-sided pneumothorax. Immediate thoracic closed drainage was performed and his dyspnea was rapidly improved. With five more times negative PCR tests for SARS-CoV-2 virus, the patient was discharged and home quarantine.
Conclusion:
This case highlights the importance for clinicians to pay attention to the appearance of spontaneous pneumothorax, especially patients with severe pulmonary damage for a long course, as well as the need for early image diagnose CT and effective treatment once pneumothorax occurs.
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