Postpneumonectomy Empyema in the Presence of COVID-19 Pneumonia after Non-COVID-19 ARDS

Abstract

Development of pleural empyema with or without bronchopleural fistula following pneumonectomy presents a major complication with a mortality of 10 to 20%. The surgical goals of bronchopleural fistula treatment are infection control, pus drainage, and lung re-expansion. The main goal is closure of the fistula. This can be achieved with various surgical methods, such as the Clagett or accelerated Weder procedure, omentoplasty, or a transpericardial approach, according to Abruzzini. We present the case of a 58-year-old patient with pleural empyema within the postpneumonectomy cavity in the presence of severe COVID-19 pneumonia after non-COVID-19 acute respiratory distress syndrome (ARDS) and extracorporeal membrane oxygenation (ECMO) therapy. The patient had undergone right-sided pneumonectomy for destroyed lung syndrome after invasive pulmonary aspergillosis

Keywords

• pleural empyema
• pyothorax
• SARS COVID-19 infection
• pneumonectomy
• aspergillosis
• bronchial stump insufficiency