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Pneumologie 2022; 76(09): 629-632
DOI: 10.1055/a-1771-5345
Case Report

Large pneumatocele as a rare complication in SARS-CoV-2 infection of the lung

Große Pneumatocele als seltene Komplikation einer SARS-CoV2-Pneumonie
Adrian Gillissen
1   Medizinische Klinik 3 (Pulmonary Medicine), Kreiskliniken Reutlingen GmbH, Reutlingen, Germany
,
Thomas Zimmermann
2   Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Kreiskliniken Reutlingen GmbH, Reutlingen, Germany
,
Stephan Clasen
3   Institut für Diagnostische und Interventionelle Radiologie, Kreisklinken Reutlingen GmbH, Reutlingen, Germany
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Abstract

In this paper, we present a case of SARS-CoV2-Virus a non-vaccinated 54-year-old male admitted with COVID-19 pneumonia and respiratory insufficiency requiring high-flow oxygen supplementation. CT-scan of the lung revealed multifocal bilateral ground-glass opacities and – as a rare complication – a large pneumatocele in the middle of the posterior part of the left lower lobe. In order to treat the pneumatocele, a 10 F was placed into the cavity. The resulting pneumothorax was successfully treated with a 20 F chest tube over a 9-day period. The pneumatocele shrank only slightly. This case demonstrates a unique radiologic finding in COVID-19, which is likely the result of severe inflammation secondary to SARS-CoV-2 including an unfruitful attempt at depressurisation.

Zusammenfassung

Es wird ein Fall eines nicht gegen das SARS-CoV-2-Virus geimpfter 54-jähriger Mann mit einer COVID-19-Pneumonie und einer respiratorischen Insuffizienz vorgestellt, der wegen der Hypoxie High-Flow-Sauerstofftherapie-pflichtig war. In den CT-Thoraxschichten zeigten multifokale, bilateral ausgeprägte Verdichtungen mit einem Milchglasphänomen und – als seltene Komplikationen – eine große Pneumatozele im mittleren Abschnitt des posterioren Anteils des linken Lungenoberlappens. Wegen des Ausmaßes wurde zunächst eine 10 F-Drainage in diese plaziert. Der resultierende Pneumothorax musste dann für 9 Tage mit einer 20 F-Thoraxdrainage versorgt werden. Darunter schrumpfte die Pneumatozele nur leicht. Dieser Falle präsentiert a) eine seltene Komplikation einer COVID-19-Pneumonie, wobei die Pneumatocele als indirekte Folge einer ausgedehnten SARS-CoV-2-bedingten intrapulmonalen Entzündung interpretiert wurde, und b) einen frustranen Therapieversuch das Ausmaß der Pneumatocele mittels einer Drainage substantiell zu reduzieren.

Schlüsselwörter

Pneumatozele - Pneumothorax - SARS-CoV-2 - Pneumonie

Keywords

Pneumatocele - pneumothorax - SARS-CoV-2 - pneumonia


Publication History

Received: 10 January 2022

Accepted after revision: 10 February 2022

Article published online:
03 May 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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