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Pneumatocele after recovering from COVID-19
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  1. Hiroshi Sugimoto1,
  2. Yukiko Era2 and
  3. Keisuke Sugimoto1
  1. 1Department of Respiratory Medicine, Kobe Red Cross Hospital, Kobe, Hyogo, Japan
  2. 2Department of Internal Medicine, Kobe Red Cross Hospital, Kobe, Hyogo, Japan
  1. Correspondence to Dr Hiroshi Sugimoto; dr.sugimoto{at}gmail.com

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Description

A 50-year-old Japanese man presented at our hospital with a week-long history of fever and dry cough. He had never smoked and had no notable medical history. Chest CT revealed bilateral ground-glass opacities (figure 1A). The diagnosis of COVID-19 was confirmed by reverse transcription-PCR for SARS-CoV-2. We administered subcutaneous heparin and oral dexamethasone for 5 days; he was discharged on day eight of admission. Follow-up CT showed bilateral consolidations (figure 1B) 4 days after discharge. One week later, he experienced sudden chest discomfort and haemoptysis. Chest CT revealed a de novo pneumatocele in the right lower lobe (figure 1C), which was carefully managed conservatively as a complication of COVID-19.

Figure 1

Chest CT. (A) Bilateral ground-glass opacities consistent with COVID-19. (B) Bilateral consolidations after recovering from COVID-19. (C) A de novo pneumatocele in the right lower lobe.

Lung cystic changes occur in up to 10% of COVID-19 cases.1 Pneumatocele is a thin-walled cystic lesion associated with acute pneumonia, and it often resolves spontaneously.2 Ruptured pneumatocele can lead to pneumothorax3; thus, careful follow-ups should be required. Although the incidence and mechanism of pneumatocele formation are still unclear in COVID-19, diffuse alveolar damage due to SARS-CoV-2 infection followed by the necrosis of the airway walls can cause pneumatocele.2

Learning points

  • Although the incidence and mechanism of pneumatocele formation are still unclear in COVID-19, diffuse alveolar damage due to SARS-CoV-2 infection followed by the necrosis of the airway walls can cause pneumatocele.

  • We clinicians should be attentive to the occurrence of pneumatocele as a complication of COVID-19, and careful follow-ups are required because ruptured pneumatocele can lead to pneumothorax.

References

Footnotes

  • Contributors HS drafted the manuscript. YE and KS revised 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.

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

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