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Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report

Received: 17 July 2021     Accepted: 10 August 2021     Published: 12 October 2021
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Abstract

The coronavirus disease 2019 (COVID-19) is now rapidly spreading at a much faster rate than the first wave reported in December 2019. Computed tomography (CT) scans play crucial roles in the diagnosis of COVID-19 pneumonia where rRT-PCR test reported negative in strong clinical suspicion. Common chest radiological findings in COVID-19 are bilateral peripheral ground-glass opacities, consolidation, linear opacities and interstitial thickening. However, bilateral cavitary lung disease is a rare entity in COVID-19. Hare, we present the case of a 62-year-old patient with severe COVID-19 pneumonia with initial rRT-PCR was negative for COVID-19 and who had atypical manifestations of the COVID-19 disease on a CT scan showing multiple cavitation with consolidation in the lungs. Special blood investigations showed raised blood procalcitonin, galactomannan, fibrinogen, D- dimer and BAL fluid pseudomonas aeruginosa growth and raised galactomannan. However, deteriorated on antibiotics along with antifungal drugs and supportive treatment. On high suspicion of viral pneumonia repeated rRT-PCR for COVID-19 came positive leading to fatal outcome.

Published in Advances in Surgical Sciences (Volume 9, Issue 2)
DOI 10.11648/j.ass.20210902.13
Page(s) 25-27
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

COVID-19, Pulmonology Cavitation, Computed Tomography, rRT-PCR

References
[1] World Health Organization. Coronavirus disease 2019 (COVID-19) situation report. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports; accessed 8 April 2021).
[2] Chinese Society of Radiology. Radiological diagnosis of new coronavirus infected pneumonitis: expert recommendation from the Chinese Society of Radiology (First edition). Chin J Radiol 2020; 54: 279–85.
[3] Shi HS, Han XY, Jiang NC, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis 2020; 20: 425–34.
[4] Selvaraj V, Dapaah-Afriyie K Lung cavitation due to COVID-19 pneumonia BMJ Case Reports CP 2020; 13: e237245.
[5] 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: 541–4. 10.3348/kjr.2020.0180 [PMC free article] [PubMed] [CrossRef] [Google Scholar].
[6] Zoumot, Z., Bonilla, MF., Wahla, A. S. et al. Pulmonary cavitation: an under-recognized late complication of severe COVID-19 lung disease. BMC Pulm Med 2021: 24. https://doi.org/10.1186/s12890-020-01379-1.
[7] Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for Coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology. 2020; 296 (2): E32–40.
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[9] Yang W, Sirajuddin A, Zhang XC, et al. The role of imaging in 2019 novel coronavirus pneumonia (COVID-19). Eur Radiol 2020; DOI: 10.1007/ s00330-020-06827-4.
[10] Ajlan AM, Ahyad RA, Jamjoom LG, Alharthy A, Madani TA. Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR Am J Roentgenol. 2014; 203 (4): 782–7.
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[12] Wong KT, Antonio GE, Hui DSC, et al. severe acute respiratory syndrome: radiographic appearances and pattern of progression in 138 patients. Radiology. 2003; 228 (2): 401–6. https://doi.org/10.1148/radiol.2282030593.
Cite This Article
  • APA Style

    Arjun Kumar, Ayushi Sahu, Rahul Kumar Gupta, Manju Bala, Akhlesh, et al. (2021). Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report. Advances in Surgical Sciences, 9(2), 25-27. https://doi.org/10.11648/j.ass.20210902.13

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    ACS Style

    Arjun Kumar; Ayushi Sahu; Rahul Kumar Gupta; Manju Bala; Akhlesh, et al. Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report. Adv. Surg. Sci. 2021, 9(2), 25-27. doi: 10.11648/j.ass.20210902.13

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    AMA Style

    Arjun Kumar, Ayushi Sahu, Rahul Kumar Gupta, Manju Bala, Akhlesh, et al. Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report. Adv Surg Sci. 2021;9(2):25-27. doi: 10.11648/j.ass.20210902.13

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  • @article{10.11648/j.ass.20210902.13,
      author = {Arjun Kumar and Ayushi Sahu and Rahul Kumar Gupta and Manju Bala and Akhlesh and Avishek Layek},
      title = {Pulmonary Cavitation Post COVID-19 Pneumonia: A Case Report},
      journal = {Advances in Surgical Sciences},
      volume = {9},
      number = {2},
      pages = {25-27},
      doi = {10.11648/j.ass.20210902.13},
      url = {https://doi.org/10.11648/j.ass.20210902.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20210902.13},
      abstract = {The coronavirus disease 2019 (COVID-19) is now rapidly spreading at a much faster rate than the first wave reported in December 2019. Computed tomography (CT) scans play crucial roles in the diagnosis of COVID-19 pneumonia where rRT-PCR test reported negative in strong clinical suspicion. Common chest radiological findings in COVID-19 are bilateral peripheral ground-glass opacities, consolidation, linear opacities and interstitial thickening. However, bilateral cavitary lung disease is a rare entity in COVID-19. Hare, we present the case of a 62-year-old patient with severe COVID-19 pneumonia with initial rRT-PCR was negative for COVID-19 and who had atypical manifestations of the COVID-19 disease on a CT scan showing multiple cavitation with consolidation in the lungs. Special blood investigations showed raised blood procalcitonin, galactomannan, fibrinogen, D- dimer and BAL fluid pseudomonas aeruginosa growth and raised galactomannan. However, deteriorated on antibiotics along with antifungal drugs and supportive treatment. On high suspicion of viral pneumonia repeated rRT-PCR for COVID-19 came positive leading to fatal outcome.},
     year = {2021}
    }
    

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    AB  - The coronavirus disease 2019 (COVID-19) is now rapidly spreading at a much faster rate than the first wave reported in December 2019. Computed tomography (CT) scans play crucial roles in the diagnosis of COVID-19 pneumonia where rRT-PCR test reported negative in strong clinical suspicion. Common chest radiological findings in COVID-19 are bilateral peripheral ground-glass opacities, consolidation, linear opacities and interstitial thickening. However, bilateral cavitary lung disease is a rare entity in COVID-19. Hare, we present the case of a 62-year-old patient with severe COVID-19 pneumonia with initial rRT-PCR was negative for COVID-19 and who had atypical manifestations of the COVID-19 disease on a CT scan showing multiple cavitation with consolidation in the lungs. Special blood investigations showed raised blood procalcitonin, galactomannan, fibrinogen, D- dimer and BAL fluid pseudomonas aeruginosa growth and raised galactomannan. However, deteriorated on antibiotics along with antifungal drugs and supportive treatment. On high suspicion of viral pneumonia repeated rRT-PCR for COVID-19 came positive leading to fatal outcome.
    VL  - 9
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Author Information
  • Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Rishikesh, India

  • Department of Pulmonary Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, India

  • Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Rishikesh, India

  • Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Rishikesh, India

  • Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Rishikesh, India

  • Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Rishikesh, India

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