Successful endobronchial occlusion in empyema with broncho‐pleural fistula secondary to COVID‐19 pneumonia: a case report and literature review

Abstract

A few cases of empyema secondary to coronavirus disease 2019 (COVID‐19) pneumonia have been reported. Here, we report our experience of a successful endobronchial occlusion using endobronchial Watanabe spigots (EWSs) for empyema with broncho‐pleural fistula secondary to COVID‐19 pneumonia. A 62‐year‐old man was diagnosed with COVID‐19 and progressed to empyema with broncho‐pleural fistula. Computed tomography (CT) imaging showed cyst formation and the right B 5 b was presumed to be a branch dependent on the cyst. The effusion and air in the pleural cavity were well drained, although the air leak persisted. Endobronchial occlusion was performed for right B 5 a and B 5 b using 7‐ and 5‐mm EWSs (Novatech, France), respectively, and the air leak ceased. This is the first report of successful treatment of empyema with bronchial fistula with endobronchial occlusion. Air leak secondary to COVID‐19 pneumonia with a limited number of air cysts may be a good indication for endobronchial occlusion.

Acute Pleural Empyema Secondary to COVID-19 Treated with Negative-Pressure Wound Therapy, Resulting in Good Lung Expansion and Early Wound Closure

“…In our case, the empyema cavity was closed approximately 50 days after OWT and the lung expanded well, suggesting that the procedure was somewhat effective. There are few reports of pleural empyema with BPFs after COVID-19, which are often treated invasively 7) , and while pleural empyema with BPF is often secondary to lung resection and pleural empyema secondary to COVID-19, as seen in this case, generally does not require lung resection. This finding suggests that NPWT is a good option for the treatment of pleural empyema secondary to COVID-19.…”

Bilateral parapneumonic pleural effusion with pneumothorax in a patient with covid 19 pneumonia: case report

“…Five cases of empyema secondary to COVID‐19 have been reported to date, including two cases of pleural fistula. All five patients were treated with surgical intervention, such as decortication, and four of these cases resulted in a good clinical course [10] . Our case is the first presentation of bilateral infected hydropneumothorax in the patient with COVID 19 pneumonia treated without surgical intervention.…”

“…Both heart failure and pulmonary embolism in addition to respiratory co-infections are well-recognized aetiologies of pleural effusions [8] . A few cases of a complicated parapneumonic effusion (empyema) secondary to coronavirus disease 2019 (COVID-19) pneumonia have been reported [ 9 , 10 , 11 ].…”