Title: COVID 19 Pneumonia with Massive Tubercular Lung Empyema: Challenges in Diagnosis & Management

Authors: Urvashi Khan, Anil Kumar, Ashok Kumar, Debapriya Sarkar

 DOI: https://dx.doi.org/10.18535/jmscr/v9i1.31

Abstract

Background

COVID 19 Pandemic as a Acute viral syndrome has many challenges in early diagnosis as well as appropriate management in time. As the pandemic is progressing we are seeing new challenging cases everyday whether it is related to comorbid issues, difficulty in diagnosis, difficult radiological interpretation or difficult clinical judgement. Early intervention and diagnosing atypical cases can lead to reduction in mortality in this pandemic. In the present case report, we report a successful management of  a patient with chief complaints of fever, dyspnea and cough with expectoration  since 5 days with COVID RTPCR positive. She was incidentally found to have a left side massive empyema on chest xray and further Evaluation. Following thoracocentesis, she was diagnosed to have underlying tubercular empyema. Therapeutic thoracocentesis resolved the empyema. At follow up, patient is better and have complete re expansion of the lung tissue.

References

  1. Tu H, Tu S, Gao S, Shao A, Sheng J. The epidemiological and clinical features of COVID-19 and lessons from this global infectious public health event. Journal of Infection. 2020 Apr 18.
  2. Rolling updates on coronavirus disease (COVID-19).Rolling Updates on Corona virus disease (COVID-19). World Health Organization. Updated https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen
  3. Empyema – do we enough? https://doi.org/10.1099/acmi.fis2019.po0154
  4. Gupta K, Stuewe E, Barry M. Asymptomatic man with an incidental finding of a massive empyema. BMJ Case Reports CP. 2020 Sep 1;13(9):e237178.
  5. Rodrigues JC, Hare SS, Edey A, Devaraj A, Jacob J, Johnstone A, McStay R, Nair A, Robinson G. An update on COVID-19 for the radiologist- A British society of Thoracic Imaging statement. Clinical radiology. 2020 May 1;75(5):323-5.

Corresponding Author

Anil Kumar

Santosh Medical College Hospital, Ghaziabad, UP, India