Rare Combination of Pneumothorax, Pneumomediastinum and Pneumopericardium and a Bronchopleural Fistula in Covid-19

[摘要] A 78-year-old man presented with a one-week history of worsening shortness of breath and cough. On examination, he had obvious respiratory distress and was profoundly hypoxic, requiring high-flow oxygen. Chest radiography revealed severe consolidation in both lung fields (Figure 1). FIGURE 1: Chest radiograph on admission showing bilateral diffuse ground-glass opacities.Covid-19 was confirmed by SARS-CoV-2 detection in nasopharyngeal and oropharyngeal swab samples using RT-PCR. Intravenous corticosteroids, immune modulators, and therapeutic anticoagulants were initiated. However, the patient required ongoing high-flow oxygen to maintain oxygen saturation.Computed tomography (CT) of the thorax revealed ground-glass opacities in both lung fields with a right pneumothorax, pneumopericardium, and pneumomediastinum, and a bronchopleural fistula (Figures 2 and Figure 3). The patient was treated conservatively owing to his frailty. He was discharged from hospital to palliative care.

[学科分类] 农业科学（综合）