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新型冠状病毒肺炎与肺部空洞性病变

COVID-19 and Cavitary Lesion in Lung.

作者信息

Vangara Avinash, Rahmlow Tara Hendrickson, Gullapalli Dedeepya, Kommineni Sai Subramanyam, Haroon Moeez, Ganti Subramanya Shyam

机构信息

Internal Medicine Residency Program, Appalachian Regional Healthcare, Harlan, USA.

Internal Medicine/Pulmonary Critical Care, Appalachian Regional Healthcare, Harlan, USA.

出版信息

Cureus. 2023 Jan 23;15(1):e34098. doi: 10.7759/cureus.34098. eCollection 2023 Jan.

Abstract

The clinical manifestations of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are widespread, ranging from asymptomatic to critical illness with significant morbidity and mortality. It is widely known that individuals who have viral respiratory infections are more likely to develop bacterial infections. Throughout the pandemic, despite the fact that COVID-19 was thought to be the primary cause of millions of deaths, bacterial coinfections, superinfections, and other secondary complications played a significant role in the increased mortality rate. In our case, a 76-year-old male presented to the hospital complaining of shortness of air. Polymerase chain reaction (PCR) testing was positive for COVID-19 and cavitary lesions were discovered on imaging. Treatment was guided based on the results of bronchoscopy with bronchoalveolar lavage (BAL) cultures showing methicillin-resistant (MRSA) and . However, the case was later complicated by the development of a pulmonary embolism after anticoagulants were held due to new onset hemoptysis. Our case highlights the importance of considering bacterial coinfection in cavitary lung lesions, appropriate antimicrobial stewardship, and close follow-up for full recovery in COVID-19 infections.

摘要

由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)临床表现广泛,从无症状到危重症,伴有显著的发病率和死亡率。众所周知,患有病毒性呼吸道感染的个体更易发生细菌感染。在整个疫情期间,尽管COVID-19被认为是数百万人死亡的主要原因,但细菌合并感染、重叠感染及其他继发并发症在死亡率增加方面起了重要作用。在我们的病例中,一名76岁男性因气促入院。聚合酶链反应(PCR)检测显示COVID-19呈阳性,影像学检查发现有空洞性病变。根据支气管镜检查及支气管肺泡灌洗(BAL)培养结果显示耐甲氧西林金黄色葡萄球菌(MRSA)等情况指导治疗。然而,该病例后来因新出现咯血停用抗凝剂后发生肺栓塞而复杂化。我们的病例强调了在COVID-19感染的空洞性肺病变中考虑细菌合并感染、适当的抗菌药物管理以及密切随访以实现完全康复的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b4e/9946277/48e3721c215d/cureus-0015-00000034098-i01.jpg

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