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Images in Thorax
COVID-19 pneumonitis and cystic lung disease, pneumothorax and pneumomediastinum
  1. Serenydd Everden1,
  2. Irfan Zaki1,
  3. Gareth Trevelyan1,
  4. James Briggs2
  1. 1 Department of Respiratory Medicine, Royal Berkshire NHS Foundation Trust, Reading, UK
  2. 2 Department of Radiology, Royal Berkshire NHS Foundation Trust, Reading, UK
  1. Correspondence to Dr Serenydd Everden, Department of Respiratory Medicine, Royal Berkshire NHS Foundation Trust, Reading RG1 5AN, UK; serenydd.everden{at}googlemail.com

https://doi.org/10.1136/thoraxjnl-2021-217390

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    Case presentation

    A 57-year-old man with no medical history and <5 pack-year smoking history presented with dyspnoea. Presentation was 4 days (day 13 from first presentation) post a 9-day admission with COVID-19 pneumonitis (SARS-CoV-2 PCR positive day 0) treated with nasal cannula oxygen and 9 days of dexamethasone. Repeat CXR (day 13) was unchanged and there was no biochemical evidence of bacterial infection. A CT pulmonary angiogram (day 13) showed extensive bilateral predominantly peripheral subpleural cystic areas of consolidation, with admixed ground glass changes consistent with COVID-19 pneumonitis (figure 1A). He remained stable and was discharged.

    Figure 1

    (A) Day 13 CTPA: showing bilateral cystic areas. (B) Day 18 CT Thorax: progression of known cyst (black arrow) and formation of new cyst (white arrow). (C) Day 63 CT Thorax: improvement in size of fluid-filled cyst (black arrow). CTPA, CT pulmonary angiogram.

    He re-presented on day 15 with dyspnoea, …

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    Footnotes

    • Contributors SE: writing main bulk of text, editing, referencing. IZ: conceived idea, editing, image selection. GT: writing first draft of case presentation, editing. JB: advice regarding description of images. Final draft editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.