Severe Hemoptysis Associated with Bacterial Pulmonary Infection: Clinical Features, Significance of Parenchymal Necrosis, and Outcome

Carteaux, Guillaume; Contou, Damien; Voiriot, Guillaume; Khalil, Antoine; Carette, Marie-France; Antoine, Martine; Parrot, Antoine; Fartoukh, Muriel

doi:10.1007/s00408-017-0064-8

Cited by 9 publications

(9 citation statements)

References 38 publications

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“…In both cases, evidence of parenchymal necrosis of the lungs as a complication of the SARS-CoV-2-induced pneumonia was found. This pattern is in accordance with past findings that the occurrence of hemoptysis in nontuberculous lower respiratory tract infections is strongly associated with necrotizing pneumonia [ 2 ]. Pulmonary hemorrhage seems to be a rare but still recurring complication of SARS-CoV-2-infection.…”

Section: Discussionsupporting

confidence: 93%

“…Rapidly progressing necrotizing pneumonia has been reported in patients with bacterially superinfected influenza pneumonia [ 3 ]. In patients with necrotizing pneumonia, affection of pulmonal artery vasculature was seen in about 40% of the cases [ 2 ]. Considering the high prevalence of capillary microthrombosis and high inflammatory burden as well as a significant rate of bacterial coinfection in patients suffering from severe COVID-19, the ideal basis for necrotizing pneumonia is given.…”

Section: Discussionmentioning

confidence: 99%

“…After resection of the problematic lobe, the toddler could be weaned off vvECMO support immediately and was discharged home 2 weeks later [ 17 ]. In a monocentric observation study, all patients that underwent surgery for therapy-refractory pulmonary bleeding in necrotizing pneumonia survived and were discharged alive from the ICU [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary hemorrhage is a recurring finding in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and has been reported in 17% of cases with severe coronavirus disease 2019 (COVID-19) on extracorporeal support [ 1 ]. Necrotizing pneumonia is strongly associated with the occurrence of pulmonary hemorrhage and severely elevated inflammatory markers and comes with a poor prognosis [ 2 , 3 ]. It can induce profound parenchyma damage and lead to severe complications such as spontaneous hemothorax.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous massive hemothorax as a complication of necrotizing pneumonia in a patient with severe acute respiratory syndrome coronavirus 2 induced acute respiratory distress syndrome: a case report

et al. 2021

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Background We present an unusual bleeding complication in a patient with severe acute respiratory distress syndrome in coronavirus disease 2019. Case presentation The patient, a 63-year-old Caucasian man, received venovenous extracorporeal membrane oxygenation support after rapid deterioration of lung function on day 6 after admission to hospital. After initial stabilization on lung protective ventilation and prone positioning, he started to develop mild bleeding complications until he went into occult profound hemorrhagic shock. Causative was a massive hemothorax of the right hemithorax with mediastinal shifting due to spontaneous bleeding from a pulmonal artery in a heavily remodeled right inferior lobe. Histopathological examination of the resected tissue showed signs of an organizing fibrinous pneumonia with focal parenchyma necrosis. After surviving a massive bleeding event caused by necrotizing pneumonia, the patient made a swift recovery and was discharged to rehabilitation 31 days after initial hospital admission. Conclusions The combination of severely elevated inflammatory markers and pulmonary hemorrhage should arouse suspicion of necrotizing pneumonia. In necrotizing pneumonia, the possibility of severe intrathoracic bleeding complications should be kept in mind if it comes to sudden deterioration of the patient.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous massive hemothorax as a complication of necrotizing pneumonia in a patient with severe acute respiratory syndrome coronavirus 2 induced acute respiratory distress syndrome: a case report

et al. 2021

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“…Most autopsy reports describe hyaline membrane changes and microvessel thrombosis in patients with COVID-19 [36]. Pulmonary bleeding is a recurrent finding in patients with COVID-19 and has been reported in 17% of severe cases receiving extracorporeal support [37]. Necrotizing pneumonia is strongly associated with the occurrence of pulmonary hemorrhage and severely elevated inflammatory markers and is associated with a poor prognosis [38,39].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Spontaneous Hemothorax, Chylothorax, Pleural, and Pericardial Effusion in Patients Who Had Thorax Tomography during Prepandemic and Pandemic Period

Türkdoğan¹,

Coşkun²,

Türkdoğan³

2022

Preprint

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Background: Coronavirus disease 2019 (COVID-19) remains a mystery in many respects. The importance of less common life-threatening diseases is still unclear. Therefore, in this study, it was attempted to determine the frequency of nontraumatic hemothorax, chylothorax, pleural, and pericardial effusion (PCE) in patients who underwent thoracic computed tomography during the pre-pandemic and pandemic period. Materials and Methods: This retrospective study included 147 patients over the age of 18 who were admitted to the emergency department between January 1st, 2019, and December 31st, 2020. The year 2019 was taken as the pre-pandemic period and the year 2020 was the pandemic period. Comorbidity, survival, and laboratory parameters of the patients were evaluated. Results: The mean age of the 147 patients included in the study was 66.41 ± 12.81 years, 54 (36.7%) were female, and the age range was 22–88 years. The mean plasma lactate dehydrogenase (LDH) level of the patients was 373.97 ± 115.77 U/L, plasma protein was 5.45 ± 1.00 gr/dL, fluid LDH was 229.37 ± 125.73 U/L, fluid/plasma LDH was 0.60 ± 0.23, fluid/plasma protein was 0.55 ± 0.29, and the amount of fluid discharged was 562.11 ± 243.01 mL. Bilateral lung involvement was present in 72 (49%) patients, and coagulation use was present in 59 (40.1%) patients. Pleural effusion (PE) was found in 43 (76.8%) of the hospitalized patients, hemothorax in 11 (19.6%) patients, and chylothorax in 4 (7.1%) patients. However, PCE was more common in the 16 (42.1%) patients admitted to the intensive care unit (ICU) (P < 0.001). While 38 (25.9%) of the patients were admitted to the ICU, mortality was observed in 30 (20.4%) patients. Conclusion: Although PE, nontraumatic hemothorax, chylothorax, and PCE are rare in COVID-19 patients, they can cause severe inflammation and poor prognosis.

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Desarrollo de enfermedades concomitantes en pacientes críticos con COVID-19

Puig

Giménez-Milà

Campistol

et al. 2021

Revista Española de Anestesiología y Reanimación

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Puede ser necesaria una reflexión sobre cuál es el mejor abordaje a las enfermedades agudas concomitantes que pueden desarrollar los pacientes críticos con COVID-19. Estos requieren una sospecha diagnóstica y un tratamiento precoz, basados en el trabajo de equipos multidisciplinares. Presentamos dos casos de enfermedades concomitantes en pacientes con COVID-19. Un paciente diagnosticado de COVID-19 con buena evolución respiratoria que tras extubación presentó una colecistitis acalculosa y un paciente con neumonía por COVID-19 que presentó una sobreinfección con neumonía necrotizante cuyo primer síntoma fue hemoptisis y fue finalmente tratado con embolización arterial por radiología intervencionista.

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Severe Hemoptysis Associated with Bacterial Pulmonary Infection: Clinical Features, Significance of Parenchymal Necrosis, and Outcome

Cited by 9 publications

References 38 publications

Spontaneous massive hemothorax as a complication of necrotizing pneumonia in a patient with severe acute respiratory syndrome coronavirus 2 induced acute respiratory distress syndrome: a case report

Spontaneous massive hemothorax as a complication of necrotizing pneumonia in a patient with severe acute respiratory syndrome coronavirus 2 induced acute respiratory distress syndrome: a case report

Frequency of Spontaneous Hemothorax, Chylothorax, Pleural, and Pericardial Effusion in Patients Who Had Thorax Tomography during Prepandemic and Pandemic Period

Desarrollo de enfermedades concomitantes en pacientes críticos con COVID-19

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