Spontaneous Pneumomediastinum Associated With SARS-CoV-2: Infrequent Complication of the Novel Disease

Spontaneous Pneumomediastinum Associated With SARS-CoV-2: Infrequent Complication of the Novel Disease.

• Urszula Wegner
• Gerardo Jeffery
• Octavio Abrajan
• Italo Sampablo
• Chitrangada Singh

抄録

44歳の男性は、既往歴も併存疾患もなく、息切れ、筋肉痛、吐き気、疲労感が著しく増加していた。急性呼吸器感染症のエピソードの前には、診断された病状はなく、健康状態も良好であった。喫煙、肺気腫、慢性肺疾患の既往歴はなかった。CT検査では，主に末梢に両側性のグランドグラス不透視が認められた．画像スペクトルと新型コロナウイルスの世界的流行から，典型的なSARS-CoV-2（重症急性呼吸器症候群コロナウイルス2）感染が疑われた．ウイルス量は生化学的データと検査結果から確認された．興味深いことに，集中的な治療にもかかわらず，入院2週目に突然の合併症を発症した．症状は薬理学的治療と非侵襲的酸素補給で消失し始めたが，その後数週間で消失した．本研究では，新型SARS-CoV2胸部感染症ではまれにみられる自然肺中胸部の発症例を例示し，考察した．我々の患者は急性呼吸窮迫症候群やそれ以上の合併症を発症しなかったが，本症例は，合併症の迅速な診断とその後の適切な管理を確実に行うために，基本的な放射線モニタリングの重要性を浮き彫りにした．

A 44-year-old male with no previous medical history or comorbidities presented with significantly increasing shortness of breath, myalgia, nausea, and fatigue. He had no diagnosed medical conditions and enjoyed good health prior to the episode of acute respiratory infection. There was no history of smoking, emphysema, or chronic lung diseases. CT revealed bilateral ground-glass opacities in predominantly peripheral distribution. Based on imaging spectrum and global pandemic of the novel coronavirus, typical SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection was suspected. Viral load was confirmed with biochemical data and laboratory results. Interestingly, despite intensive treatment, the patient developed sudden complications during the second week of his hospitalization. The symptoms started to resolve on pharmacological treatment and supplemental noninvasive oxygen supply over the next weeks. We illustrate and discuss the case of spontaneous pneumomediastinum as an uncommon manifestation of novel SARS-CoV2 chest infection. Even though our patient did not develop acute respiratory distress syndrome or further complications, the presented case highlights the importance of basic radiological monitoring of the disease in order to ensure prompt diagnosis of complications and appropriate subsequent management.

Copyright © 2020, Wegner et al.