Severe COVID-19 Pneumonia Complicated by Pneumothorax, Pneumomediastinum, and Pneumoperitoneum

A 50-year-old man was presented with a 4-day history of fever and diarrhea. He experienced shortness of breath on the day of presentation. Physical examination indicated that the patient was in severe respiratory distress. His respiratory rate was 45 breaths/min, and his oxygen saturation was 93% wi...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2021-04, Vol.104 (6), p.1951-1952
Main Authors: Ahmed, Ashraf O E, Mohamed, Mouhand F H, Ahmed, Khalid
Format: Article
Language:English
Subjects:
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - pathology
COVID-19 - therapy
Emphysema
Humans
Images in Clinical Tropical Medicine
Male
Mediastinal Emphysema - etiology
Middle Aged
Pneumoperitoneum - etiology
Pneumothorax
Pneumothorax - etiology
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
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Summary:A 50-year-old man was presented with a 4-day history of fever and diarrhea. He experienced shortness of breath on the day of presentation. Physical examination indicated that the patient was in severe respiratory distress. His respiratory rate was 45 breaths/min, and his oxygen saturation was 93% with 15 L of oxygen/minute via a nonrebreathing mask. A chest examination showed diffuse crepitations. Nasopharyngeal swabbing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yielded positive results. The C-reactive protein and ferritin levels were elevated. The chest X-ray (CXR) examination revealed bilateral lower zone infiltrates. Soon after admission, acute kidney injury developed and hemodialysis was started. Three days later, shortness of breath and desaturation developed; therefore, he was intubated and had a central line inserted (right jugular). The postprocedural CXR examination results were unremarkable. Coronavirus disease 2019 (COVID-19) has been reported to cause pneumothorax, which can worsen rapidly under the circumstances of mechanical ventilation because it can act as a shearing force that intensifies air leak into the mediastinum and even to the peritoneum.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.21-0092