Post-COVID-19 pneumonia pneumatoceles: a case report

Abstract

Introduction Pneumatocele formation in COVID-19 pneumonia is arguably a common occurrence. Case Presentation We present a case of pneumatoceles, developing as a sequel of COVID-19 infection. We argue that pneumatocele formation in COVID-19 pneumonia is a common occurrence. Importantly pneumothorax, which can lead to a raised morbidity and mortality in these patients, can be a complication of a pneumatocele rupture. Conclusion As pneumatocele in COVID-19 pneumonia patients can lead to life-threatening complications, we emphasize the need to formulate appropriate and standardized monitoring and management guidelines. Our literature review also discusses various plausible mechanisms leading to pneumatocele formation and points to management strategies that may prevent pneumatocele formation and its complications.

Pop Goes the Lung: Bilateral Pneumothoraces Due to Delayed Pneumatocele Rupture in Coronavirus Disease 2019 (COVID-19)

“…They represent pulmonary tissue without discrete epithelial wall. As patients with COVID-19 are having increased radiographic surveillance, pneumatoceles are being found incidentally or as a result of a significant illness [ 9 , 10 ]. Although some pneumatoceles can be identified on routine chest radiographs, CT chest imaging would have improved sensitivity for detecting small pneumatoceles and evaluating the surrounding lung for consolidation and ground-glass opacities [ 10 ].…”

“…It is possible that pneumothorax that results during COVID-19 can be related to the development and spontaneous rupture of otherwise clinically insignificant pneumatoceles. There are multiple case reports of lung pathology identified on imaging, like the case report by Jamal et al, who described a large pneumatocele without rupture in a young otherwise healthy adult with COVID-19 that elutes with time [ 10 ]. This is in contrast to Pyae and Arif, who described a similar case of a 64-year-old with COVID-19 complicated by pulmonary embolism that has delayed pneumothorax from pneumatocele rupture 20 days after hospitalization [ 11 ].…”