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New disease
Case report
Development of bullous lung disease in a patient with severe COVID-19 pneumonitis
  1. Samuel Berhane1,
  2. Adam Tabor1,
  3. Ajay Sahu2,
  4. Anand Singh1 and
  5. Rebecca Phillips1
  1. 1Respiratory Medicine, London North West Healthcare NHS Trust, London, UK
  2. 2Radiology, Ealing Hospital, London, UK
  1. Correspondence to Dr Samuel Berhane; samuel.berhane{at}nhs.net

Abstract

A 60-year-old man presented with sudden onset right-sided chest pain and gradually worsening shortness of breath on exertion. Eleven days earlier, he had an admission with COVID-19 pneumonitis requiring 8 days of continuous positive airway pressure. He was tachypnoeic with a respiratory rate of 24 breaths/min, oxygen saturations on room air of 91%. Examination revealed reduced air entry and a resonant percussion note over the right hemithorax. Chest radiograph suggested a complex right pneumothorax; however, a CT chest was notable for widespread right-sided bullous lung disease. After a day of observation on a COVID-19 ward (and a repeat radiograph with a stable appearance), he was discharged with a 2-week follow-up with the respiratory team, safety netting advice and ambulatory oxygen. This case suggests that bullous lung disease may be a complication of severe COVID-19 pneumonitis.

  • respiratory medicine
  • mechanical ventilation

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2020-237455

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    Footnotes

    • Correction notice This article has been corrected since it was published Online. The author's name "Dr Rebecca Phillips" has been added to the author byline in this article. The contribution section has also been updated.

    • Contributors SB admitted the patient on medical take and wrote and edited the majority of the article. AT and RP looked after the patient on the ward and wrote the first draft of some of the article. ASa is a consultant radiologist who reviewed images initially and contributed to radiological description. ASi is the lead consultant in charge of the patients care during both admissions and reviewed article drafts before submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.