Purpose Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed pneumothorax in rare cases, but tension pneumothorax has only been reported once. Case presentation A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided tension pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the pneumothorax and the patient was discharged after 9 days of treatment. Conclusion Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute tension pneumothorax. Level of evidence V Electronic supplementary material The online version of this article (10.1007/s15010-020-01457-w) contains supplementary material, which is available to authorized users.
【저자키워드】 COVID-19, Pneumonia, viral infections, Pneumothorax, Multidetector computed tomography, 【초록키워드】 Treatment, coronavirus disease, SARS-CoV-2, Coronavirus disease 2019, therapy, Azithromycin, SARS-COV-2 infection, sputum, emergency department, Computed tomography, polymerase chain reaction, IgG antibody, PCR, Chest, Fever, male, breath, Patient, complications, Pneumothorax, severe pneumonia, distribution, consolidation, patients, COVID-19 patients, Antibody titre, Dyspnoea, Evidence, Regression, COVID-19 patient, Oxygenation, Chain Reaction, (Polymerase Chain Reaction, tension pneumothorax, Negative pressure, open thoracotomy, supportive therapy, sore throat, Non-invasive, supplementary material, dry cough, consolidations, pulmonary complications, coughing, physician, positive, Relieved by, tension, recent, treating, polymerase chain, develop, reported, the patient, discharged, Level, pulmonary complication, 【제목키워드】 Case report, tension, secondary,