Pneumothorax in patient with pneumonia caused by SARS-CoV-2: Case report

Introduction The coronavirus disease 2019 (COVID-19) is an acute infectious multisystem disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), manifested by acute respiratory symptoms The novel coronavirus pneumonia (NCP) is the most common serious clinical manifestation of SARS-CoV-2 infection In the severe NCP, the systemic manifestations of the disease were also demonstrated, and one of the rare complications, first described in Wuhan (China), is pneumothorax Case report A 65-year-old female was admitted to the Clinic for Pulmonology with a high fever, shortness of breath, sore throat, and general weakness that started five days before Laboratory findings revealed lymphopenia, elevated values of inflammatory markers, and liver lesion A chest X-ray (CXR) demonstrated diffusely accentuated interstitial pattern and reduced parenchymal transparency, left perihilar Positive SARS-CoV-2 in a nasopharyngeal swab sample was detected in the real-time reverse transcriptionpolymerase chain reaction (RT-PCR), confirming the diagnosis of NCP Immediately, nasal oxygen therapy with a flow rate of 8 L/min, with chloroquine phosphate, antibiotics, and symptomatic treatment, was initiated On the 8th day, her condition suddenly deteriorated, and she developed severe hypoxemia A repeated CXR showed complete left-sided pneumothorax Thoracic drainage was successfully performed with complete reexpansion of the lungs the very next day The patient was released from the hospital in good general condition with normal arterial blood gases Conclusion Pneumothorax may develop as a complication in patients with pneumonia caused by SARS-CoV-2, without previous pulmonary comorbidities, due to alveolar damage Acute deterioration with rapid oxygen desaturation in these patients should raise the suspicion of pneumothorax Early diagnosis and prompt treatment are necessary to reduce mortality (English) [ABSTRACT FROM AUTHOR] Uvod Koronavirusna bolest 2019 (COVID-19) je akutna, infektivna multisistemska bolest koja se najcesce manifestuje akutnim respiratornim simptomima Izaziva je severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Nova koronavirusna pneumonija (NCP) je najcesca ozbiljna klinicka manifestacija SARS-CoV-2 infekcije U teskoj NCP ispoljene su i sistemske manifestacije bolesti, a jedna od retkih komplikacija, prvi put opisana u Vuhanu (Kina), je pneumotoraks Prikaz bolesnika Bolesnica stara 65 godina primljena je u Kliniku za pulmologiju zbog febrilnosti, otežanog disanja, gusobolje i opste malaksalosti koje je imala prethodnih 5 dana Laboratorijskim ispitivanjem otkriveni su limfopenija, povisene vrednosti parametara zapaljenja i lezija jetre Radiografijom (RDG) grudnog kosa utvrđeno je difuzno naglasen intersticijum i smanjena transparencija parenhima levo perihilarno Prisustvo SARSCoV- 2 u uzorku nazofaringealnog brisa otkriveno je lancanom reakcijom polimeraze (PCR), cime je potvrđena dijagnoza NCP Odmah je zapoceta terapija kiseonikom preko nazalne kanile protoka 8 L/min, uz hlorokin fosfat, antibiotike i simptomatsku terapiju Osmog dana, stanje bolesnice se naglo pogorsalo i razvila je tesku hipoksemiju Ponovljenom RDG grudnog kosa potvrđen je kompletan pneumotoraks levo Torakalna drenaža je uspesno izvedena uz potpunu reekspanziju pluca vec sledeceg dana Bolesnica je otpustena iz bolnice u dobrom opstem stanju, sa normalnim gasovima arterijske krvi Zakljucak Usled ostecenja alveola, pneumotoraks kao komplikacija pneumonije izazvane SARS-CoV-2, može nastati bez prethodnih plucnih oboljenja Akutno pogorsanje sa naglom desaturacijom kiseonikom kod tih bolesnika trebalo bi da pobudi sumnju na pneumotoraks Rana dijagnoza i brzo lecenje su neophodni za smanjenje smrtnosti (Bosnian) [ABSTRACT FROM AUTHOR] Copyright of Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia is the property of Military Medical Academy INI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )