Pneumatocele after Acute Respiratory Distress Syndrome in an Adult Patient: A Case Report

Abstract

Pulmonary pneumatocele is a cystic, air-filled lesion in the lung parenchyma. It results from underlying inflammation or bronchial injury. It is seen in several lung pathologies including bacterial pneumonia, positive-pressure ventilation, chest trauma, chemical pneumonitis, and is most often seen in infants and children. On imaging, pneumatoceles appear as rounded, thin-walled, air-filled spaces in the lung parenchyma. The exact mechanism for forming pneumatoceles is not fully understood but thought to be due to a check-valve mechanism due to obstruction by inflammation causing air trapping in the damaged lung. These lesions are asymptomatic and transient in most patients and disappear by about 6 weeks. They usually do not require any specific treatment or intervention. Surgical intervention is only necessary when pneumatoceles cause cardiopulmonary compromise or rupture into the pleural space. We describe a case of a young adult who developed a pneumatocele after developing acute respiratory distress syndrome from community-acquired pneumonia treated with positive-pressure ventilation. He was managed conservatively with complete resolution of symptoms.

Pneumatocele Induced Pneumothorax in a patient with Post-COVID-19 Pneumonitis. A Case Report

“…In this case, while no pneumatocele was identified before or at presentation, antecedent rupture of an unacknowledged pneumatocele could have led to the pneumothorax. The single pneumatocele lesion likely formed due to parenchymal inflammation secondary to ARDS, which is not uncommon (15). There have not been any studies that deduce a specific mechanism for COVID-19 infection itself eliciting pneumatocele formation, without pneumonitis underplay.…”

Pneumatocele Manifestation in Early Recovery Period of COVID-19: A Case Study

“…A pneumatocele is a thin-walled, cystic, air-filled lesion present within the lung parenchyma. Its occurrence may present secondary to multiple aetiologies such as chest trauma, bacterial pneumonia, particularly, Streptococcus and Staphylococcus aureus pneumonia, chemical toxicity, such as hydrocarbon ingestion and positive-pressure ventilation [ 2 ]. Pneumatoceles are typically rare in the adult population; they tend to occur in infants, children, and adolescents, and there are only a few adult cases noted in literature.…”

“…A pneumatocele is a thin-walled, cystic, air-filled lesion present within the lung parenchyma. Its occurrence may present secondary to multiple aetiologies such as chest trauma, bacterial pneumonia, chemical toxicity and positive-pressure ventilation [ 2 ]. These lesions are typically asymptomatic and usually self-resolve without requirement of specific treatment or intervention [ 2 ].…”

Treatment of a pneumatocele in a COVID-19 patient with endobronchial valves

“… 1 However, these complications are also seen in several other conditions including bacterial pneumonia, positive-pressure ventilation, chest trauma and chemical pneumonitis. 2 In patients with COVID-19, lung injury is thought to result from exaggerated inflammation induced by viral replication and then sustained by a cytokine storm associated with disease severity. 3 4 The inflammation may lead to increased vulnerability of the lung parenchyma.…”

“…In the course of severe COVID-19 pneumonia, spontaneous pneumomediastinum and pneumothorax unrelated to positive-pressure ventilation have been reported as unusual complications 1. However, these complications are also seen in several other conditions including bacterial pneumonia, positive-pressure ventilation, chest trauma and chemical pneumonitis 2. In patients with COVID-19, lung injury is thought to result from exaggerated inflammation induced by viral replication and then sustained by a cytokine storm associated with disease severity 3 4.…”