Bronchopleural fistula development in the setting of novel therapies for acute respiratory distress syndrome in SARS-CoV-2 pneumonia

Published by Elsevier Inc. on behalf of University of Washington..

COVID-19 pneumonia has demonstrated a wide spectrum of clinical presentations that has yet to be completely uncovered. We discuss the case of a 49-year-old male who presented to the emergency department with fever, cough, and shortness of breath. Initial chest X-ray suggested viral pneumonia that was confirmed to be due to COVID-19. He was treated with empiric antibiotics, antiviral therapy, high-dose glucocorticoids, and interleukin antagonists. Two weeks into the patient's hospital course, he rapidly decompensated with subsequent chest X-ray and CT chest confirming tension pneumothorax with bronchopleural fistula. Intraoperative samples of the necrotic empyema identified mucormycosis invading the lung parenchyma with follow-up microbiology results confirming Rhizopus species. In this case report, we explore the possibility that the patient's immunocompromised state may have contributed to the patient's development of mucormycosis and subsequent development of bronchopleural fistula.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Radiology case reports - Vol. 15, No. 11 (2020), p. 2378-2381

Language:

English

Contributors:

Placik, Daniel A
Taylor, Wesley L
Wnuk, Nathan M

Links:

Volltext

Keywords:

COVID
Case Reports
Dexamethasone
Mucormycosis
Pneumonia
Remdesivir
Tocilizumab

Notes:

Date Revised 01.10.2020

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/j.radcr.2020.09.026

PMID:

32983308

PPN (Catalogue-ID):

NLM316502960