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Published on: January 17, 2011
Bronchopleural Fistula Following COVID-19 and Necrotizing Pneumonia in Childhood: Treatment With Intrapleural
Jose Carlos Fraga1, Felipe Colombo Holanda2, Natalia Zanini Silva3
1Pediatric Thoracic and Airway Surgery Units, Hospital de Clínicas de Porto Alegre, Department of Surgery, School of Medicine Universidade Federal do Rio Grande do Sul Porto Alegre Brazil.
Abstract:
Bronchopleural fistula is an abnormal communication between the bronchial tree and the pleural space. Necrotizing pneumonia is a catastrophic infection of the lungs characterised by necrosis of the interstitial tissue. Although rarely reported, it has been described as a complication of COVID-19. The usual treatment for bronchopleural fistula involves endoscopic or surgical procedures. We present the case of a 5-year-old girl admitted with necrotizing pneumonia and difficult-to-control bronchopleural fistula, with a report of flu-like illness and a positive PCR test for COVID-19 2 months earlier. Over 38 days, several procedures were performed, including left-side tube drainage, thoracotomy, segmental resection, open window thoracotomy, and finally vacuum-assisted closure (VAC) therapy. Twenty days after the start of VAC therapy, complete closure of the bronchopleural fistula was achieved. At 26 months of follow-up, the child remained asymptomatic, with radiological examinations showing pulmonary expansion and absence of intrapleural air.
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