Hampson Frances, Salih Waleed, Helm Jennifer
Department of Radiology, Salford Royal NHS Foundation Trust, Salford, UK.
Department of Respiratory Medicine, Salford Royal NHS Foundation Trust, Salford, UK.
Eur J Case Rep Intern Med. 2021 Jun 28;8(7):002605. doi: 10.12890/2021_002605. eCollection 2021.
A 39-year-old man presented with severe COVID-19 pneumonitis requiring hospital admission. He represented three days following discharge with sudden onset breathlessness and chest pain. Initial imaging suggested the presence of a left pneumothorax. Following further clinical decline a plan was made to insert a CT guided chest drain. However, imaging in the prone position for the procedure unexpectedly revealed a large left lower lobe pneumatocele with only a very small pneumothorax. Events and appearances suggest that this is a rare case of delayed COVID-19 pneumonitis-related pneumatocele formation. We will discuss the clinical significance of this entity.
Pneumatocele formation should be considered in patients presenting with new respiratory symptoms after completing therapy for COVID-19 pneumonitis.Performing CT examinations with patients in different positions may be required to help exclude the possibility of pneumatocele formation when a loculated pneumothorax is suspected on the supine CT images.
一名39岁男性因严重的COVID-19肺炎入院治疗。出院三天后，他因突发呼吸困难和胸痛再次就诊。初始影像学检查提示左侧气胸。随着病情进一步恶化，计划进行CT引导下胸腔闭式引流。然而，在进行该操作时的俯卧位成像意外发现左肺下叶有一个大的肺气囊，仅有非常小的气胸。事件及表现提示这是一例罕见的COVID-19肺炎相关肺气囊形成延迟的病例。我们将讨论该实体的临床意义。
对于COVID-19肺炎治疗结束后出现新的呼吸道症状的患者，应考虑肺气囊形成的可能。当仰卧位CT图像怀疑有局限性气胸时，可能需要对患者进行不同体位的CT检查，以帮助排除肺气囊形成的可能性。
