Bilateral Spontaneous Pneumothorax as Manifestation of COVID-19: Case Report
Case Report
DOI:
https://doi.org/10.55175/cdk.v53i02.1647Keywords:
Case report, COVID-19, spontaneous pneumothorax, tension pneumothoraxAbstract
Introduction: Spontaneous pneumothorax occurs when part of the lung collapses and air accumulates in the pleural space. The cause of spontaneous pneumothorax is unclear, but this condition may increase the risk of death, particularly if it progresses to tension pneumothorax.
COVID-19 is primarily a respiratory disease and may present with various pulmonary manifestations, including rare and severe complications. Case: A 48-year-old woman presented with dyspnea, fever, cough, nausea, and fatigue. Initial rapid antibody testing for SARS-CoV-2 was
negative. Chest radiograph demonstrated an avascular area in the right lateral hemithorax with medial lung collapse, consistent with right spontaneous pneumothorax. Oxygen therapy and chest tube insertion were performed. Follow up chest x-ray showed resolution of the right
pneumothorax, however, a new pneumothorax developed on the left side. Nasopharyngeal and oropharyngeal swab testing for SARS-CoV-2 was reported positive a few days later, after the patient had died. Discussion: The occurrence of bilateral spontaneous pneumothorax
in this patient suggests lung involvement related to COVID-19 infection. Recognition of atypical pulmonary manifestations is essential, particularly when initial screening tests are negative. Conclusion: COVID-19 can manifest as spontaneous pneumothorax, including bilateral involvement. Early recognition is important to reduce morbidity and mortality.
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References
Li Q, Guan X, Wu P, Wang XY, Zhou L, Tong YQ, et al. Early transmission dynamics of novel coronavirus-infected pneumonia in Wuhan, China. N Engl J Med. 2020;382(13):1199–207. doi: 10.1056/NEJMoa2001316.
World Health Organization. WHO director-general's opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
Bunawan NC, Nugraha S, Harlivasari A, Diponegoro S, Nugroho HM. Coronavirus disease 2019 (COVID-19) with sole gastrointestinal symptom: sase series. Internat J Med Rev Case Rep. 2021;5:1. doi: 10.5455/IJMRCR.Sole-Gastrointestinal-Symptom-covid-19-172-1608221469.
Elrobaa IH, New KJ. COVID-19: pulmonary and extra pulmonary manifestations. Front Public Health. 2021;9:711616. doi: 10.3389/fpubh.2021.711616.
Martinelli AW, Ingle T, Newman J, Nadeem I, Jackson K, Lane ND, et al. COVID-19 and pneumothorax: a multicentre retrospective case series. Eur Respir J. 2020;56(5):2002697. doi: 10.1183/13993003.02697-2020.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507–13. doi: 10.1016/s0140-6736(20)30211-7.
Bunawan NC, Sinto R, Harlivasari A, Nugroho HM, Wistriany N, Diponegoro S, et al. Sistem penapisan COVID-19 RSUD Kramat Jati. Internat J Chest. 2021;7(2):32–9.
Agrafiotis AC, Rummens P, Lardinois I. Pneumothorax in otherwise healthy non-intubated patients suffering from COVID-19 pneumonia: a systematic review. J Thorac Dis. 2021;13(7):4519–29. doi: 10.21037/jtd-21-208.
Quincho-Lopez A, Quincho-Lopez DL, Hurtado-Medina FD. Case report: pneumothorax and pneumomediastinum as uncommon complications of COVID-19 pneumonia-literature review. Am J Trop Med Hyg. 2020;103(3):1170–6. doi: 10.4269/ajtmh.20-0815.
Yang F, Shi SB, Zhu JL, Shi JZ, Dai K, Chen XB. Analysis of 92 deceased patients with COVID-19. J Med Virol. 2020;92(11):2511–5. doi: 10.1002/jmv.25891.
Sihoe AD, Wong RH, Lee AT, Lai LS, Leung NY, Law KI, et al. Severe acute respiratory syndrome complicated by spontaneous pneumothorax. Chest. 2004;125(6):2345–51. doi: 10.1378/chest.125.6.2345.
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(5):541–4. doi: 10.3348/kjr.2020.0180.
Yuki K, Fujiogi M, Koutsogiannaki S. COVD-19 pathophysiology: a review. Clin Immunol. 2020;215:108427. doi: 10.1016/j.clim.2020.108427.
Mallick T, Dinesh A, Engdahl R, Sabado M. COVID-19 complicated by spontaneous pneumothorax. Cureus. 2020;12(7):e9104. doi: 10.7759/cureus.9104.
Tarig Sami E, Haleem SA, Carlos Pelaez R, Rodriguez-Fuentes Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. BMJ Case Rep. 2020;13(12):e239489. doi: 10.1136/bcr-2020-239489.
Hussain A, Noorani A, Deshpande R, John L, Baghai M, Wendler O, et al. Management of pneumothorax in mechanically ventilated COVID-19 patients: early experience. Interact Cardiovasc Thorac Surg. 2020;31(4):540–3. doi: 10.1093/icvts/ivaa129.
Zantah M, Dominguez Castillo E, Townsend R, Dikengil F, Criner GJ. Pneumothorax in COVID-19 disease- incidence and clinical characteristics. Respir Res. 2020;21(1):236. DOI: 10.1186/s12931-020-01504-y.
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Copyright (c) 2026 Edgar David Sigarlaki, Nur Chandra Bunawan, Nasya Amalia, Annisa Dian Harlivasari, Cathleen Kenya, Yoni Vanto, Hardijatmo Muljo Nugroho
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