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

Abstract

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.

Lung Abscess as a Delayed Complication in a COVID-19 Pneumonia Patient: A Case Report

“…It is a type of pulmonary infection in which a cavity forms in the lung parenchyma and develops an air-fluid level. 2 It belongs to the class of lung illnesses including lung gangrene and necrotizing pneumonia, both of which exhibit numerous abscesses. It can be classified as primary (driven by the aspiration of oropharyngeal secretions, necrotizing pneumonia, and immunodeficiency) or secondary (precipitated by other ailments, such as bronchial obstruction, hematogenic dissemination, direct spread from a mediastinal infection of the subphrenic space, or coexisting lung disease).…”

“…Aspiration pneumonia primarily causes pneumonitis, which evolves into tissue necrosis in 1-2 weeks if left untreated. 2 COVID-19 infection can burden the immune system, making the body more susceptible to secondary infection by viruses or bacteria. Any additional infection causes more lung damage; in this case, it was a lung abscess.…”

“…11,12 Lung abscesses frequently form in the posterior segment of the right upper lobe and middle lobe, followed by the superior segment of the right lower lobe, and less frequently in the left lung following aspiration of oropharyngeal contents. 2 Acute lung abscess is typically surrounded by poorly defined lung parenchyma filled with thick necrotic detritus. 2 Lung abscess can be diagnosed via plain radiograph, which typically shows a cavity containing an air-fluid level, CT scan with contrast to identify abscess margins, and sputum and blood culture to identify the causative organism, such as Staphylococcus aureus, Klebsiella, Pseudomonas, and Proteus.…”

“…1 The presence of fever, cough, and dyspnea often heralds the acute viral illness of COVID-19. 2,3 A large percentage of COVID-19 patients experience numerous complications, such as thromboembolism, arrhythmias, encephalopathy, pneumothorax, and lung abscess. 2,4 A lung abscess is a type of pulmonary infection in which a cavity forms in the pulmonary parenchyma and develops an air-fluid level.…”

“…2,3 A large percentage of COVID-19 patients experience numerous complications, such as thromboembolism, arrhythmias, encephalopathy, pneumothorax, and lung abscess. 2,4 A lung abscess is a type of pulmonary infection in which a cavity forms in the pulmonary parenchyma and develops an air-fluid level. 3 Lung abscess has been reported as a late complication of COVID-19.…”