COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad
  • Erika Poggiali
    Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Andrea Vercelli
    Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
  • Teresa Iannicelli
    Ospedale Guglielmo da Saliceto, Emergency Department, Piacenza, Italy
  • Valentina Tinelli
    Ospedale Guglielmo da Saliceto, Emergency Department, Piacenza, Italy
  • Laura Celoni
    Ospedale Guglielmo da Saliceto, Emergency Department, Piacenza, Italy
  • Andrea Magnacavallo
    Ospedale Guglielmo da Saliceto, Emergency Department, Piacenza, Italy

Keywords

COVID-19, pneumonia, dyspnoea, pneumothorax, COPD, ARDS

Abstract

We describe the case of a male patient admitted to our emergency department during the Italian COVID-19 epidemic, for progressive worsening dyspnoea. A diagnosis of pneumothorax and diffuse interstitial lung involvement was promptly made by lung ultrasound and confirmed by an HRCT scan. A chest CT scan also showed diffuse emphysema, as observed in chronic obstructive pulmonary disease (COPD), and small consolidations in the lower lobes, suggestive for COVID-19 pneumonia. A chest tube was immediately inserted in the emergency room with complete resolution of the dyspnoea. A nasopharyngeal swab for 2019-nCoV was positive. Unfortunately, the patient died from COVID-19-related acute respiratory distress syndrome after 48 days of hospitalization.

VIEW THE ENTIRE ARTICLE

References

  • Husain LF, Hagopian L, Wayman D, Baker WE, Carmody KA. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock 2012;5(1):76–81.

  • Blaivas M, Lyon M, Duggal S. A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax. Acad Emerg Med 2005;12:844–849.

  • Soldati G, Testa A, Sher S, Pignataro G, La Sala M, Silveri NG. Occult traumatic pneumothorax: diagnostic accuracy of lung ultrasonography in the emergency department. Chest 2008;133:204–211.

  • Huang Y, Huang H, Li Q, Browning RF, Parrish S, Turner JF, et al. Approach of the treatment for pneumothorax. J Thorac Dis 2014;6(Suppl 4):S416–S420.

  • Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary. Am J Respir Crit Care Med 2001;163:1256–1276.

  • Takahashi M, Fukuoka J, Nitta N, Takazakura R, Nagatani Y, Murakami Y, et al. Imaging of pulmonary emphysema: a pictorial review. Int J Chron Obstruct Pulmon Dis 2008;3(2):193–204.

  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.

  • Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al.
    COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med 2020 Apr 14;1–4. doi: 10.1007/s00134-020-06033-2. [Epub ahead of print].

  • Poggiali E, Dacrema A, Bastoni D, Tinelli V, Demichele E, Mateo Ramos P, et al. Can lung ultrasound help critical care clinicians in the early diagnosis of novel coronavirus (COVID-19) pneumonia? Radiology 2020;295(3):E6.

  • Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8(4):420–422.

  • Sun R, Liu H, Wang X. Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol 2020; 21(5):541–544.

  • Kim HC, Choi SH, Huh JW, Sung H, Hong SB, Lim CM, et al. Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia. J Med Virol 2016;88(12):2092–2099.
  • Views: 1512
    HTML downloads: 864
    PDF downloads: 703


    Published: 2020-06-01
    Issue: 2020: Vol 7 No 7 (view)


    How to cite:
    1.
    Poggiali E, Vercelli A, Iannicelli T, Tinelli V, Celoni L, Magnacavallo A. COVID-19, Chronic Obstructive Pulmonary Disease and Pneumothorax: A Frightening Triad. EJCRIM 2020;7 doi:10.12890/2020_001742.

    Most read articles by the same author(s)