Bronchopleural fistula associated persistent pneumothorax in a patient recovering from COVID‐19 pneumonia: A case report

• Published in: Clinical case reports 2023-09, Vol.11 (9), p.n/a
• Main Authors: Regmi, Milan, Karki, Anurag, Shrestha, Moon, Pathak, Nibesh, Bhandari, Sanjeev, Sharma, Niraj Kumar, Pant, Pankaj
• Format: Article
• Language: English
• Subjects: Allergy; Anesthesia; Antibiotics; Asymptomatic; bronchopleural fistula; Cardiothoracic Surgery; Cardiovascular Disorders; Case Report; Case reports; Chest tubes; Coronaviruses; COVID-19; COVID‐19 pneumonia; Fistula; Intervention; Lung diseases; Lungs; Patients; Pneumonia; Pneumothorax; respiratory complications; Thoracic surgery
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.7989

Key Clinical Message Pneumothorax and bronchopleural fistula (BPF) are potentially fatal complications that can occur in patients with COVID‐19 pneumonia. Early detection, appropriate treatment, and consideration of surgical intervention are necessary for optimum outcomes. Introduction Healthcare professionals face complex challenges as a result of the rare emergence of pneumothorax among the variety of COVID‐19 complications, including severe viral pneumonia. Case History A 57‐year‐old male with multiple comorbidities diagnosed with COVID‐19 pneumonia was admitted to our center and exhibited bilateral crepitations. During hospitalization, the patient developed right‐sided pneumothorax that persisted despite chest tube insertion was linked to the presence of BPF. Discussion The occurrence of pneumothorax in COVID‐19 patients is relatively rare risk factors for which are not yet fully understood, although smoking history may play a role. Conservative management is recommended for asymptomatic cases, while intercostal drainage is necessary for symptomatic patients. Surgical intervention may be required to manage the BPF in some instances. Conclusion Pneumothorax and BPF are rare but potentially life‐threatening complications in patients recovering from COVID‐19 pneumonia. Early recognition, appropriate treatment, and consideration of surgical intervention are crucial for optimizing patient outcomes. In a patient recovering from COVID‐19 Pneumonia, a chest X‐ray showed pneumothorax on the right in Figure (A). In contrast, in Figure (B), a chest X‐ray done four days before showed no pneumothorax with bilateral opacities without any subpleural bullae. HRCT Chest done later revealed a Bronchopleural Fistula leading to persistent pneumothorax in this patient.