Document Type : Case Report

Authors

1 Chemical Injury Research Center, Baqiyatallah University of Medical Sciences, Tehran

2 Trauma Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

3 Department of Skin and Hair Diseases, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Community Medicine, Faculty of Medicine, Baqiatallah University of Medical Science, Tehran, Iran

Abstract

Introduction: pneumomediastinum and pneumothorax is usually a rarer condition after pnomonia. This study examines the progress of pneumonia of the COVID-19 to spontaneous pneumothorax and pneumomediastinum in a patient
Case Presentation: The patient was a 40-year-old man who complained of nonproductive cough and dyspnea. He also complained of fever, sore throat, back and chest pain. The patient had previously smoked and had now quit .His O2 saturation was 89% at the time of admission. He was assessed with suspicion of COVID-19. CT scans of the chest showed brief changes of emphysema and grand glass view was also seen in the lungs. In the patient's tests,RT‐PCR testing of SARS‐CoV‐2 was performed and it was positive. Treatment was initiated and because of progression of symptoms, the serial CT scanning of the patient’s lungs was performed daily and cavitary changes, air fluid appearance and destructive changes of lungs were reported. After eight days, the patient's cough worsened. CT scans of the patient’s lungs showed some bullaes, pneumothorax and pneumomediastenum, so chest tube was inserted and oxygen therapy was started to the patient with 3-6 lit/minute. After five day in CT, the patient was relieved of pneumothorax and pneumomediastenum and after a week, chest tube came out.
Conclusion: Pulmonary lesions of COVID 19 can progress to bullae, pneumomediastenum and pneumothorax. Deterioration of dyspnea and respiratory symptoms can be a warning of pneumomediastenum and pneumothorax that can be confirmed by graphics and timely treatment of the patient can be life-saving.

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