Bronchopleural fistula development in the setting of novel therapies for acute respiratory distress syndrome in SARS-CoV-2 pneumonia.
Bronchopleural fistula development in the setting of novel therapies for acute respiratory distress syndrome in SARS-CoV-2 pneumonia.
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DOI：
10.1016/j.radcr.2020.09.026
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发表时间：
2020-11
影响因子：
--
通讯作者：
Wnuk NM
中科院分区：
文献类型：
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作者：
Placik DA;Taylor WL;Wnuk NM
COVID-19肺炎已表现出广泛的临床表现，尚未完全发现。我们讨论的情况下，一个49岁的男性谁提出了与发热，咳嗽，呼吸急促急诊科。最初的胸部X光检查提示病毒性肺炎，经证实是由COVID-19引起的。患者接受经验性抗生素、抗病毒治疗、大剂量糖皮质激素和白细胞介素拮抗剂治疗。患者住院两周后，患者迅速失代偿，随后的胸部X线检查和胸部CT证实张力性气胸伴支气管胸膜瘘。术中坏死性脓胸样本鉴定为毛霉菌病侵入肺实质，随访微生物学结果证实为根霉菌属。在这份病例报告中，我们探讨了患者的免疫功能低下状态可能导致患者发生毛霉菌病和随后发生支气管胸膜瘘的可能性。
COVID-19 pneumonia has demonstrated a wide spectrum of clinical presentations that has yet to be completely uncovered. We discuss the case of a 49-year-old male who presented to the emergency department with fever, cough, and shortness of breath. Initial chest X-ray suggested viral pneumonia that was confirmed to be due to COVID-19. He was treated with empiric antibiotics, antiviral therapy, high-dose glucocorticoids, and interleukin antagonists. Two weeks into the patient's hospital course, he rapidly decompensated with subsequent chest X-ray and CT chest confirming tension pneumothorax with bronchopleural fistula. Intraoperative samples of the necrotic empyema identified mucormycosis invading the lung parenchyma with follow-up microbiology results confirming Rhizopus species. In this case report, we explore the possibility that the patient's immunocompromised state may have contributed to the patient's development of mucormycosis and subsequent development of bronchopleural fistula.