An unusual course of disease in two patients with COVID-19: pulmonary cavitation

Muheim, Michael; Weber, Fabio José; Muggensturm, Patrick; Seiler, Eva

doi:10.1136/bcr-2020-237967

Cited by 14 publications

(15 citation statements)

References 23 publications

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“…6 However, bacteria cannot always be isolated for various reasons. Muheim et al 8 reported that no bacteria could be isolated in patients who developed lung abscess after SARS-CoV-2 pneumonia and the treatment was empirical. In one of our cases, bacterial growths such as “ Acinetobacter baumannii, Pseudomonas aeruginosa , and Escherichia coli ” were detected in the sputum culture and appropriate antibiotics were given.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Abscess as a Complication of SARS-CoV-2 Pneumonia

Üzer

Öner

Çilli

2022

Libyan International Medical University Journal

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease originated in the Wuhan region of China and spread all over the world. This disease typically starts as an acute viral disease, and it is characterized by lung infiltrates and elevation of inflammatory markers. The definitive diagnosis of the disease is confirmed by polymerase chain reaction (PCR) results. Although majority of patients with positive PCR results had mild disease, 5 to 14% of them are severely affected. It has been reported in the literature that a significant proportion of adult patients develops virus-related complications. Lung abscess is one of these complications that is a suppurative infection with an air-fluid level greater than 2 cm in diameter on chest X-ray. Although there is usually a single cavity, it can also be multifocal. It was reported as a possible late-term complication of SARS-CoV-2. We are presenting two cases with lung abscess after SARS-CoV-2 treatment.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Abscess as a Complication of SARS-CoV-2 Pneumonia

Üzer

Öner

Çilli

2022

Libyan International Medical University Journal

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“…However, lung cavitation was described to be notably absent [ 10 ]. More recently, pulmonary abscess [ 2 , 8 , 11 , 12 , 13 ], infected pneumatoceles [ 14 ], and lung cavitation [ 11 , 15 , 16 , 17 , 18 , 19 , 20 ] have been described in COVID-19 patients. Aside from areas of consolidation with necrosis, characteristic of NP, radiologic and/or operative findings in our cohort included predominantly pulmonary abscess(es), mediastinal and/or hilar adenopathies, cavities, pneumatoceles, and pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

Post-COVID-19 Necrotizing Pneumonia in Patients on Invasive Mechanical Ventilation

Hidrón

Quiceno

Cardeño

et al. 2021

Infectious Disease Reports

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(1) Background: Few reports of necrotizing pneumonia in patients with COVID-19 have been published. We have observed an elevated incidence at two hospitals in our city, suggesting this complication is not uncommon, and may have been overlooked. (2) Methods: This article presents a retrospective, descriptive cohort study that was undertaken from 22 March 2020 to 15 June 2021 in two tertiary care hospitals in Medellín, Colombia. All adult patients admitted to the intensive care unit (ICU) for respiratory failure related to confirmed COVID-19, on invasive mechanical ventilation (IMV), with imaging or surgical findings documenting necrotizing pneumonia (NP) were included. (3) Results: Of 936 patients with COVID-19 that required IMV, 42 (4.5%) developed NP. Overall mortality was 57% and in-hospital mortality was 71%, occurring 15–79 days after COVID-19 diagnosis. NP was diagnosed at a median of 27 days after COVID-19 symptom onset and 15.5 days after initiation of IMV. Infections were polymicrobial in 52.4% of patients. Klebsiella pneumoniae (57%) and Pseudomonas aeruginosa (33%) were the most common etiologic agents. Pulmonary embolism (PE) was documented in 13 patients overall (31%), and in 50% of patients who underwent an angioCT. Drainage and/or surgical procedures were performed on 19 patients (45.2%) with a 75% mortality rate. (4) Conclusions: In our experience, NP is a relatively common, albeit neglected, complication in mechanically ventilated COVID-19 patients, possibly originating in poorly vascularized areas of lung parenchyma. Associated mortality is high. Although drainage procedures did not seem to favorably impact patient outcomes, diagnosis and treatment were late events in the overall disease course, suggesting that early recognition and timely treatment could have a positive impact on prognosis.

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“…Furthermore, a 52-year-old male developed a lung cavity 3 weeks after the diagnosis of COVID-19 was made [ 7 ]. Lastly, two 59-year-old men were reported to develop spontaneous large pulmonary cavities 1 month after COVID-19 [ 9 ]. Hence, clinicians should be aware of cavitary lung disease as an acute and late complication of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Development of cavitary lung disease as a long-term complication of coronavirus disease 2019 in a young previously healthy patient: a case report

et al. 2021

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Background Cavities are frequent manifestations of a wide variety of pathological processes involving the lung. There has been a growing body of evidence of coronavirus disease 2019 leading to a cavitary pulmonary disease. Case presentation A healthy 29-year-old Filipino male presented to the hospital a couple of months after convalescence from coronavirus disease 2019 with severe pleuritic chest pain, fever, chills, and shortness of breath, and was found to have a cavitary lung lesion on chest computed tomography. While conservative management alone failed to improve the patient’s condition, he ultimately underwent left lung video-assisted thoracoscopic surgery decortication. Even though the surgical pathology revealed only necrosis with dense acute inflammation and granulation tissue with no microorganisms, he gradually improved with medical therapy adjunct with surgical therapy. Conclusion Documented cases of cavitary lung disease secondary to coronavirus disease 2019 have been mostly reported in the acute or subacute phase of the infection. However, clinicians should recognize this entity as a late complication of coronavirus disease 2019, even in previously healthy individuals.

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An unusual course of disease in two patients with COVID-19: pulmonary cavitation

Cited by 14 publications

References 23 publications

Pulmonary Abscess as a Complication of SARS-CoV-2 Pneumonia

Pulmonary Abscess as a Complication of SARS-CoV-2 Pneumonia

Post-COVID-19 Necrotizing Pneumonia in Patients on Invasive Mechanical Ventilation

Development of cavitary lung disease as a long-term complication of coronavirus disease 2019 in a young previously healthy patient: a case report

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