Post COVID-19 pneumatocele

Case contributed by Dr Domenico Nicoletti

Presentation

Prior COVID-19 infection. The middle aged male patient presented 2 weeks after discharge with new onset of dyspnea, chills, sweating and malaise.

Patient Data

Age: 65 years
Gender: Male
X-ray

Chest radiography showed an air-cyst and air fluid level in the right lower lobe.

CT

There is a rounded, thin-walled, air-filled cavity measuring 9 x 5 x 8 cm in the apical segment of the right lower lobe that contains gas-fluid level. There are also multi focal bilateral ground-glass opacities with crazy-paving pattern near the pneumatocele in the right lower lobe.

Pathology

​Cov19 buffer report: positive.

Case Discussion

Pneumatoceles may complicate the course of COVID-19 infection. This coronavirus targets alveolar epithelial cells which together with the associated cytokine storm make the alveoli prone to rupture with subsequent air leakage and formation of cystic air space lesions. The majority of pneumatoceles usually resolve spontaneously within few weeks of onset, and the treatment is mainly directed towards the underlying infection. Sometimes in a special situation with compression of the surrounding lung and cardiorespiratory compromise or accumulation of pus inside, image-guided catheter drainage is advocated as a first-line strategy.

Case courtesy: Dr.ssa Laura Venerandi

 

Radiographer: TSRM Fabio Imola

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.