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Secondary tension pneumothorax in a COVID-19 pneumonia patient: a case report.

Authors
  • Spiro, Judith E1
  • Sisovic, Snezana2
  • Ockert, Ben3
  • Böcker, Wolfgang3
  • Siebenbürger, Georg4
  • 1 Department of Radiology, University Hospital, LMU Munich, Munich, Germany. , (Germany)
  • 2 Department of Internal Medicine IV-Endocrinology, Munich University Hospitals, Ludwig-Maximilians-University, Munich, Germany. , (Germany)
  • 3 Department of General, Trauma and Reconstructive Surgery, Munich University Hospitals, Ludwig-Maximilians-University, Nussbaumstr. 20, 80336, Munich, Germany. , (Germany)
  • 4 Department of General, Trauma and Reconstructive Surgery, Munich University Hospitals, Ludwig-Maximilians-University, Nussbaumstr. 20, 80336, Munich, Germany. [email protected] , (Germany)
Type
Published Article
Journal
Infection
Publisher
Springer-Verlag
Publication Date
Dec 01, 2020
Volume
48
Issue
6
Pages
941–944
Identifiers
DOI: 10.1007/s15010-020-01457-w
PMID: 32557347
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed pneumothorax in rare cases, but tension pneumothorax has only been reported once. A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided tension pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the pneumothorax and the patient was discharged after 9 days of treatment. Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute tension pneumothorax. V.

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