Article Text
Abstract
The COVID-19 pandemic has had a significant impact on the structure and operation of healthcare services worldwide. We highlight a case of a 64-year-old man who presented to the emergency department with acute dyspnoea on a background of a 2-week history of fever, dry cough and shortness of breath. On initial assessment the patient was hypoxic (arterial oxygen saturation (SaO2) of 86% on room air), requiring 10 L/min of oxygen to maintain 98% SaO2. Examination demonstrated left-sided tracheal deviation and absent breath sounds in the right lung field on auscultation. A chest radiograph revealed a large right-sided tension pneumothorax which was treated with needle thoracocentesis and a definitive chest drain. A CT pulmonary angiogram demonstrated segmental left lower lobe acute pulmonary emboli, significant generalised COVID-19 parenchymal features, surgical emphysema and an iatrogenic pneumatocoele. This case emphasises the importance of considering coexisting alternative diagnoses in patients who present with suspected COVID-19.
- pneumothorax
- respiratory medicine
- pulmonary embolism
- tropical medicine (infectious disease)
- radiology
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Footnotes
Contributors RK is the lead author in this case report and played a significant role in writing the manuscript, obtaining consent and following up the patient. FTFJ contributed to writing the manuscript and clerked the patient in the emergency department. RN is a clinical fellow in respiratory medicine who was involved in the care of the patient and contributed to writing the manuscript. SH is a consultant chest radiologist who provided expert opinion, supervised and contributed to writing the manuscript.
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.