COVID-19 Pneumonia with Cavitation

Kesimal U., Durmaz S. O.

FLORA INFEKSIYON HASTALIKLARI VE KLINIK MIKROBIYOLOJI DERGISI, vol.26, no.3, pp.560-564, 2021 (ESCI) identifier identifier


The World Health Organization officially named the disease as Coronavirus Disease 2019 (COVID-19), which was caused by a new type of coronavirus that leads to viral pneumonia on 11 February 2020. Typical computed tomography findings of the disease are ground-glass infiltrations in both lungs. Atypical findings include lung cavitation and pleural effusion. A 43-year-old female patient was admitted to the emergency room with complaints of dry cough, fatigue, and joint pain for three days. Bilateral peripherally localized multisegmented ground-glass infiltrates were present in the first thorax tomography. A combined nasopharyngeal swab was taken from the patient and favipiravir and hydroxychloroquine treatment was initiated and she was sent home with the recommendation of isolation for 14 days. Real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) test performed on the same day and confirmed COVID-19 diagnosis. She was admitted to the hospital again with an increase in complaints five days after the first presentation and her oxygen saturation (SpO(2)) was found to be 90%. On the fifth day of her hospitalization, the patient was discharged because of clinical improvement. Two weeks later, she was brought to the emergency room with deterioration in her general condition. On thorax tomography of the patient, an area of necrotizing pneumonia with cavitation in the lower lobe of the right lung was observed. The patient was followed up in the intensive care unit for five days. After being followed up in the COVID service for five days, she was discharged because her respiratory distress, cough and C-reactive protein (CRP) was decreased. Lung cavitation due to COVID-19 pneumonia is rare, and most cases are self-limiting. Although the last rRT-PCR test of the patient is negative, the cavitary lesion in the lung can maintain contagiousness even if it is at a low level. Therefore, the extension of treatment and isolation time should be considered in such patients.