key: cord-0725794-w7rkrx1l
authors: Sugimoto, Hiroshi; Era, Yukiko; Sugimoto, Keisuke
title: Pneumatocele after recovering from COVID-19
date: 2021-04-19
journal: BMJ Case Rep
DOI: 10.1136/bcr-2021-242729
sha: 0ff8f28ec10b65c13f7088e28d6301a0e92ee356
doc_id: 725794
cord_uid: w7rkrx1l

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A 50-year-old Japanese man presented at our hospital with a week-long history of fever and dry cough. He had never smoked and had no notable medical history. Chest CT revealed bilateral ground-glass opacities ( figure 1A) . The diagnosis of COVID-19 was confirmed by reverse transcription-PCR for SARS-CoV-2. We administered subcutaneous heparin and oral dexamethasone for 5 days; he was discharged on day eight of admission. Follow-up CT showed bilateral consolidations (figure 1B) 4 days after discharge. One week later, he experienced sudden chest discomfort and haemoptysis. Chest CT revealed a de novo pneumatocele in the right lower lobe (figure 1C), which was carefully managed conservatively as a complication of COVID-19.

Lung cystic changes occur in up to 10% of COVID-19 cases. 1 Pneumatocele is a thin-walled cystic lesion associated with acute pneumonia, and it often resolves spontaneously. 2 Ruptured pneumatocele can lead to pneumothorax 3 ; thus, careful follow-ups should be required. Although the incidence and mechanism of pneumatocele formation are still unclear in COVID-19, diffuse alveolar damage due to SARS-CoV-2 infection followed by the necrosis of the airway walls can cause pneumatocele. 2

Contributors HS drafted the manuscript. YE and KS revised the manuscript.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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Hiroshi Sugimoto http:// orcid. org/ 0000-0002-2053-8858

Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study

Pulmonary pneumatocele: pathology and pathogenesis

Management of complicated pneumatocele

► Although the incidence and mechanism of pneumatocele formation are still unclear in COVID-19, diffuse alveolar damage due to SARS-CoV-2 infection followed by the necrosis of the airway walls can cause pneumatocele. ► We clinicians should be attentive to the occurrence of pneumatocele as a complication of COVID-19, and careful follow-ups are required because ruptured pneumatocele can lead to pneumothorax. Copyright 2021 BMJ Publishing Group. All rights reserved. For permission to reuse any of this content visit https://www.bmj.com/company/products-services/rights-and-licensing/permissions/ BMJ Case Report Fellows may re-use this article for personal use and teaching without any further permission.Become a Fellow of BMJ Case Reports today and you can: ► Submit as many cases as you like ► Enjoy fast sympathetic peer review and rapid publication of accepted articles ► Access all the published articles ► Re-use any of the published material for personal use and teaching without further permission

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