Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19

Since the start of the COVID-19 pandemic, the most common clinical presentation in pediatric population is characterized by typical respiratory symptoms such as dry cough, mild dyspnea, and radiological findings with less lobar compromise than  adults. In children, depending on etiology, pn...

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Autores principales: Soria, FA, Mircovich, C, González, P, Teijeiro, A, Arbones, R
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022
Materias:
pneumothorax
teenager
covid19
neumotórax
adolescentes
covid-19
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/39001
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
id I10-R327-article-39001
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
format Artículo revista
topic pneumothorax
teenager
covid19
neumotórax
adolescentes
covid-19
spellingShingle pneumothorax
teenager
covid19
neumotórax
adolescentes
covid-19
Soria, FA
Mircovich, C
González, P
Teijeiro, A
Arbones, R
Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
topic_facet pneumothorax
teenager
covid19
neumotórax
adolescentes
covid-19
author Soria, FA
Mircovich, C
González, P
Teijeiro, A
Arbones, R
author_facet Soria, FA
Mircovich, C
González, P
Teijeiro, A
Arbones, R
author_sort Soria, FA
title Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
title_short Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
title_full Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
title_fullStr Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
title_full_unstemmed Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19
title_sort neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con covid-19
description Since the start of the COVID-19 pandemic, the most common clinical presentation in pediatric population is characterized by typical respiratory symptoms such as dry cough, mild dyspnea, and radiological findings with less lobar compromise than  adults. In children, depending on etiology, pneumothorax is classified as spontaneous, (primary or secondary) and traumatic. Primary spontaneous pneumothorax usually appears in previously healthy patients and usually results from the rupture of a subpleural bulla. Secondary spontaneous pneumothorax is caused by complication of underlying lung disease, and pneumothorax due to trauma can be caused by a wide range of lung or airway injuries, including central venous catheterization, thoracocentesis in hospitalized patients, etc. Cases associated with COVID-19 have been described in patients without predisposing factors, although their pathophysiology is still unclear. We now present a patient with recurrent spontaneous pneumothorax and possible association with SARS-CoV-2 infection, in August 2021, who did not meet the criteria for any of the known causes. A 14-year-old female patient consulted referring 2 weeks of persistent coughing, mild pain in the left parasternal region, and mild intermittent dyspnea. Medical history: previously healthy patient with no relevant history, who had COVID-19 on 07-09-2021 with mild symptoms (3-day fever, mild cough, mild dyspnea). On physical examination, the patient was eutrophic, vesicular murmur (vm) decreased in the upper region of the left lung field, pulse oximetry 96%, hemodynamically stable. Chest x-ray: image compatible with pneumothorax in the apical region of the left lung. Chest CT: massive pneumothorax. Surgical drainage is performed with discharge 7 days after hospitalization. On the 13th day after discharge, patient consults due to fainting, mild dyspnea, and sudden oppressive pain in the left hemithorax; VM was abolished in vertex and middle zone of left lung field; Chest CT scan: subpleural bulla at the apex of left lung. Surgical resection was performed by video-assisted thoracoscopy with definitive discharge after 8 days. This case is presented to report the development of recurrent pneumothorax in the absence of predisposing factors and in relation to recent SARS-CoV-2 infection, which suggests a possible connection with cytopathic effects produced by the infection at a pulmonary level.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2022
url https://revistas.unc.edu.ar/index.php/med/article/view/39001
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spelling I10-R327-article-390012024-04-15T16:14:45Z Neumotórax recidivante en paciente sin factores de riesgo y la posible asociación con COVID-19 Soria, FA Mircovich, C González, P Teijeiro, A Arbones, R pneumothorax teenager covid19 neumotórax adolescentes covid-19 Since the start of the COVID-19 pandemic, the most common clinical presentation in pediatric population is characterized by typical respiratory symptoms such as dry cough, mild dyspnea, and radiological findings with less lobar compromise than  adults. In children, depending on etiology, pneumothorax is classified as spontaneous, (primary or secondary) and traumatic. Primary spontaneous pneumothorax usually appears in previously healthy patients and usually results from the rupture of a subpleural bulla. Secondary spontaneous pneumothorax is caused by complication of underlying lung disease, and pneumothorax due to trauma can be caused by a wide range of lung or airway injuries, including central venous catheterization, thoracocentesis in hospitalized patients, etc. Cases associated with COVID-19 have been described in patients without predisposing factors, although their pathophysiology is still unclear. We now present a patient with recurrent spontaneous pneumothorax and possible association with SARS-CoV-2 infection, in August 2021, who did not meet the criteria for any of the known causes. A 14-year-old female patient consulted referring 2 weeks of persistent coughing, mild pain in the left parasternal region, and mild intermittent dyspnea. Medical history: previously healthy patient with no relevant history, who had COVID-19 on 07-09-2021 with mild symptoms (3-day fever, mild cough, mild dyspnea). On physical examination, the patient was eutrophic, vesicular murmur (vm) decreased in the upper region of the left lung field, pulse oximetry 96%, hemodynamically stable. Chest x-ray: image compatible with pneumothorax in the apical region of the left lung. Chest CT: massive pneumothorax. Surgical drainage is performed with discharge 7 days after hospitalization. On the 13th day after discharge, patient consults due to fainting, mild dyspnea, and sudden oppressive pain in the left hemithorax; VM was abolished in vertex and middle zone of left lung field; Chest CT scan: subpleural bulla at the apex of left lung. Surgical resection was performed by video-assisted thoracoscopy with definitive discharge after 8 days. This case is presented to report the development of recurrent pneumothorax in the absence of predisposing factors and in relation to recent SARS-CoV-2 infection, which suggests a possible connection with cytopathic effects produced by the infection at a pulmonary level. Desde el inicio de la pandemia COVID-19, la presentación clínica en la mayoría de la población pediátrica se caracteriza por síntomas respiratorios típicos como tos seca, disnea leve, y hallazgos radiológicos con menor afectación lobular que en adultos. En Pediatría, de acuerdo a la etiología, el neumotórax (ntx)  se clasifica en espontáneo, (primario o secundario) y  traumático. El ntx espontáneo primario aparece usualmente en una persona previamente sana y generalmente resulta de la ruptura de una bulla subpleural. El ntx espontáneo secundario es producido por complicación de una enfermedad pulmonar de base y  el ntx por trauma puede ser producido por un amplio espectro de lesiones del pulmón o las vías aéreas, entre ellas la punción venosa central, toracocentesis  en pacientes internados, etc. Se han descripto casos asociados a COVID-19, en pacientes sin factores predisponentes aunque la fisiopatogenia de los mismos aún no está clara. Presentamos una paciente con neumotórax espontaneo recidivante y posible asociación con infección por SARS-CoV-2, en agosto 2021, que no reunía los criterios para ninguna de las causas conocidas Paciente de 14 años de edad, femenino, que consulta por accesos de tos seca persistente de 2 semanas de evolución, dolor leve en región paraesternal izquierda y disnea leve discontinua. Antecedentes previos: paciente previamente sana sin ningún antecedente de relevancia, que cursó COVID-19 el 09-07-2021 con síntomas leves (fiebre de 3 días, tos escasa, disnea leve). Al examen físico, paciente eutrófica, murmullo vesicular (mv) disminuido en región superior de campo pulmonar izquierdo (cpi), saturometría de pulso 96%, hemodinámicamente estable. radiografía de tórax: imagen compatible con neumotórax en región apical de pulmón izquierdo (pi).  TAC de tórax:  neumotórax masivo. Se realiza drenaje quirúrgico con alta a los 7 días post internación. Al 13º día post alta, consulta por lipotimia, disnea leve, y dolor tipo opresivo en hemitórax izquierdo de instauración brusca; mv abolido en vértice y zona media de cpi.  TAC de tórax:  bulla subpleural en ápice de pi. Se practica resección quirúrgica mediante videotoracoscopía con alta definitiva a los 8 días. Se presenta el caso para reportar el desarrollo de neumotórax recidivante en   ausencia de factores predisponentes y en relación a la infección reciente por SARS-CoV-2, lo cual nos sugiere una posible  relación con efectos citopáticos producidos por la infección a nivel pulmonar. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/39001 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0

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