PDF(Pubmed)
Abstract：
The COVID-19 pandemic has impacted every aspect of our lives since its start in December 2019. Among various COVID-19 complications, pleural complications are also increasingly reported but rarely from Nepal. Here, we presented a case of pyopneumothorax in a 52-year-old male patient referred from another center and admitted to the ICU of Nepal Armed Police Force Hospital with a diagnosis of severe COVID-19 pneumonia in the background of alcohol withdrawal syndrome with delirium tremens and generalized tonic-clonic seizures. He developed a rapid decline in respiratory status with a right-sided pneumothorax and underwent an immediate needle thoracostomy, followed by chest tube insertion. On the sixth day of admission, he had thick yellowish pus in the chest drain (pyopneumothorax), and despite the rigorous efforts in treatment, he died on the 15th day of admission. Though relatively uncommon, clinicians should consider pleural complications like pneumothorax, pleural effusion, pneumomediastinum, and empyema in patients with impaired immune status. In such patients, we should ensure prompt diagnosis with the earliest intervention and rationale use of antibiotics.
摘要：
自2019年12月开始以来，COVID-19大流行已经影响了我们生活的方方面面。在各种COVID-19并发症中，胸膜并发症的报道也越来越多,但很少来自尼泊尔.这里,我们介绍了一例从另一中心转诊的52岁男性患者的脓性气胸病例,该患者在酒精戒断综合征伴震颤谵妄和全身性强直-阵挛性癫痫发作的背景下,入住尼泊尔武警部队医院ICU,诊断为重症COVID-19肺炎.他因右侧气胸而出现呼吸状态迅速下降，并立即进行了针式胸廓造口术，然后插入胸管。在入学的第六天，他的胸腔引流处有厚厚的黄色脓液（脓气胸），尽管在治疗方面做出了严格的努力，他在入院第15天死亡.虽然相对不常见，临床医生应该考虑胸膜并发症，如气胸，胸腔积液,纵隔肺炎，免疫状态受损患者的脓胸。在这样的病人中,我们应该通过尽早干预和合理使用抗生素来确保及时诊断。
