Taylor Elisha, Novakov Ivan
Special Surgery, Medical University Plovdiv, Plovdiv, BGR.
Cureus. 2022 Jun 30;14(6):e26464. doi: 10.7759/cureus.26464. eCollection 2022 Jun.
Pulmonary cavitation is an atypical finding in COVID-19 patients. In this rare case report, a 63-year-old woman (35 days from COVID-19 symptom onset) presented to our emergency department with acute chest pain and shortness of breath. A chest X-ray established right-sided total pneumothorax, hence a tube thoracostomy was performed. Due to a persistent air leak, chest computed tomography was performed, which showed areas of lung consolidation and a cavitary mass in the upper lobe of the right lung. The woman undertook a thoracoscopy, which established multiple petechiae on the lung surface and a bronchopleural fistula of the right lung's upper lobe. The treatment of choice was an atypical lung resection to remove the necrotic cavitary lesion. Histological and microbiological examination of the resected lung specimen showed a bland (aseptic) cavitary pulmonary infarct. Pulmonary infarction is a rare cause of cavitation in COVID-19 patients, nonetheless, something that should be considered in those presenting with respiratory symptoms or complications during or post-COVID-19.
肺空洞形成在新冠病毒感染患者中是一种非典型表现。在这份罕见病例报告中,一名63岁女性(新冠病毒感染症状出现35天)因急性胸痛和呼吸急促就诊于我院急诊科。胸部X线检查确诊为右侧全气胸,遂行胸腔闭式引流术。由于持续漏气,进行了胸部计算机断层扫描,结果显示肺部有实变区域以及右肺上叶有一个空洞性肿块。该女性接受了胸腔镜检查,发现肺表面有多处瘀点以及右肺上叶支气管胸膜瘘。首选治疗方法是行非典型肺切除术以切除坏死的空洞性病变。对切除的肺标本进行组织学和微生物学检查显示为单纯性(无菌性)空洞性肺梗死。肺梗死是新冠病毒感染患者空洞形成的罕见原因,尽管如此,对于在新冠病毒感染期间或之后出现呼吸道症状或并发症的患者仍应予以考虑。