Astımlı COVID-19 Hastasında Pnömomediastinum

Spontan pnömomediastinum alveol rüptürene bağlı gelişen nadir bir hastalıktır. Şimdiye kadar COVID-19 ile ilgili birçok pnömomediastinum vakası bildirilmiştir, ancak bu hastaların çoğunda ciddi hastalık ve yaygın parankim hasarı vardı. Pnömomediastinum, bu kadar küçük bir akciğer infiltrasyonu ile COVID-19'da oldukça nadirdir. Aşırı öksürüğün neden olduğu artmış alveoler basıncın bir sonucu olarak ortaya çıktığı varsayılmaktadır. Burada, tipik COVID-19 semptomları olan ve göğüs bilgisayarlı tomografisinde fokal buzlu cam opasitesi ve pnömomediastinumu olan ve kardiyak veya solunum komplikasyonları olmaksızın spontan gerileyen astımlı bir hastayı sunuyoruz.

Anahtar Kelimeler:

COVID-19, Pnömomediastinum, Öksürük, Alveol

Pneumomediastinum in an asthmatic patient with COVID-19

Spontaneous pneumomediastinum is a rare disease that develops due to alveolar rupture. Many cases with pneumomediastinum, related to Corona Virus Disease-19 (COVID-19) have been reported so far, but most of these patients had severe disease and extensive parenchymal damage. Pneumomediastinum is fairly rare in COVID-19 with such a little lung infiltration. It is supposed to occur as a result of the increased intra-alveolar pressure induced by an excessive cough. Here, we present a patient with asthma with typical symptoms of COVID-19 on chest computerized tomography (CT) and focal ground-glass opacity and pneumomediastinum, which spontaneously regressed without cardiac or respiratory complications.

Keywords:

COVID-19, Pneumomediastinum, Cough, Alveolus,

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1. Wali A, Rizzo V, Bille A, Routledge T, Chambers AJ. Pneumomediastinum following intubation in COVID-19 patients: a case series. Anaesthesia. 2020 Aug;75(8):1076-1081. doi: 10.1111/anae.15113. Epub 2020 Jun 11. PMID: 32375200; PMCID: PMC7267505.
2. Kolani S, Houari N, Haloua M, Alaoui Lamrani Y, Boubbou M, Serraj M, Aamara B, Maaroufi M, Alami B. Spontaneous pneumomediastinum occurring in the SARS-COV-2 infection. IDCases. 2020 May 11;21:e00806. doi: 10.1016/j.idcr.2020.e00806. PMID: 32395425; PMCID: PMC7212974.
3. Zhou C, Gao C, Xie Y, Xu M. COVID-19 with spontaneous pneumomediastinum. Lancet Infect Dis. 2020 Apr;20(4):510. doi: 10.1016/S1473-3099(20)30156-0. Epub 2020 Mar 9. PMID: 32164830; PMCID: PMC7128610.
4. Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P, Ji W. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR. Radiology. 2020 Aug;296(2):E115-E117. doi: 10.1148/radiol.2020200432. Epub 2020 Feb 19. PMID: 32073353; PMCID: PMC7233365.
5. Li Y, Yao L, Li J, Chen L, Song Y, Cai Z, Yang C. Stability issues of RT-PCR testing of SARS-CoV-2 for hospitalized patients clinically diagnosed with COVID-19. J Med Virol. 2020 Jul;92(7):903-908. doi: 10.1002/jmv.25786. Epub 2020 Apr 5. PMID: 32219885; PMCID: PMC7228231.
6. Onigbinde SO, Ojo AS, Fleary L, Hage R. Chest Computed Tomography Findings in COVID-19 and Influenza: A Narrative Review. Biomed Res Int. 2020 Jun 5;2020:6928368. doi: 10.1155/2020/6928368. PMID: 32596354; PMCID: PMC7275219.