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新型冠状病毒病 2019(COVID-19)肺炎合并自发性气胸:一例报告。

The coronavirus diseases 2019 (COVID-19) pneumonia with spontaneous pneumothorax: a case report.

机构信息

Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China.

Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.

出版信息

BMC Infect Dis. 2020 Sep 9;20(1):662. doi: 10.1186/s12879-020-05384-x.

Abstract

BACKGROUND

The outbreak of the novel coronavirus (COVID-19) that was firstly reported in Wuhan, China, with cases now confirmed in more than 100 countries. However, COVID-19 pneumonia with spontaneous pneumothorax is unknown.

CASE PRESENTATION

We reported a case of 66-year-old man infected with COVID-19, presenting with fever, cough and myalgia; The patient received supportive and empirical treatment including antiviral treatment, anti-inflammatory treatment, oxygen supply and inhalation therapy; The symptoms, CT images, laboratory results got improved after the treatments, and a throat swab was negative for COVID-19 PCR test; However, on the hospital day 30, the patient presented with a sudden chest pain and dyspnea. CT showed a 30-40% left-sided pneumothorax. Immediate thoracic closed drainage was performed and his dyspnea was rapidly improved. With five more times negative PCR tests for SARS-CoV-2 virus, the patient was discharged and home quarantine.

CONCLUSION

This case highlights the importance for clinicians to pay attention to the appearance of spontaneous pneumothorax, especially patients with severe pulmonary damage for a long course, as well as the need for early image diagnose CT and effective treatment once pneumothorax occurs.

摘要

背景

新型冠状病毒(COVID-19)首先在中国武汉爆发,目前已有 100 多个国家报告了确诊病例。然而,COVID-19 肺炎合并自发性气胸尚属未知。

病例介绍

我们报告了一例 66 岁男性感染 COVID-19 的病例,表现为发热、咳嗽和肌痛;患者接受了支持和经验性治疗,包括抗病毒治疗、抗炎治疗、氧疗和吸入治疗;治疗后症状、CT 图像、实验室结果均得到改善,咽拭子 COVID-19 PCR 检测为阴性;然而,在住院第 30 天,患者突然出现胸痛和呼吸困难。CT 显示左侧气胸 30-40%。立即进行了胸腔闭式引流,呼吸困难迅速改善。经过 5 次 SARS-CoV-2 病毒 PCR 检测均为阴性,患者出院并进行居家隔离。

结论

本病例强调了临床医生注意自发性气胸出现的重要性,特别是对于长期严重肺部损伤的患者,以及一旦发生气胸需要早期进行影像诊断 CT 和有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4fb/7488028/312a36d6e22e/12879_2020_5384_Fig1_HTML.jpg

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