Lethal case of lung gangrene against the background of viral-bacterial pneumonia (COVID-19 and Fusobacteria)

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The respiratory system is the main target of COVID-19 infection spread by the SARS-CoV-2 virus. This study presents a case of viral–bacterial pneumonia caused by SARS-CoV-2 and Fusobacteria complicated by the development of gangrene in the lower lobe of the right lung with abscess formation. Accompanied by an ambulance team for emergency reasons, the patient was admitted for inpatient treatment with complaints of pain when coughing, dyspnea, cough with mucopurulent sputum, and fever up to 39.6°С. Chest computed tomography revealed signs of viral–bacterial pneumonia. Infiltration was determined in the lower lobe of the right lung, against which a cavity with melting lung tissue was observed. A virological test of throat and nasal swabs detected SARS-CoV-2 coronavirus RNA. Despite treatment, the patient died. Autopsy revealed signs of viral–bacterial pneumonia, a decaying cavity with purulent content, and diffuse destructive changes with hemorrhages. The cause of death of the patient was COVID-19, which caused bilateral viral–bacterial pneumonia complicated by the development of gangrene in the lower lobe of the right lung with abscess formation.

Full Text

Restricted Access

About the authors

Olga V. Alpidovskaya

Chuvash State University named after I.N. Ulyanov

Author for correspondence.
Email: olavorobeva@mail.ru
ORCID iD: 0000-0003-3259-3691
SPIN-code: 5084-1379

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Cheboksary

References

  1. Curry CA, Fishman EK, Buckley JA. Pulmonary gangrene: radiologic and pathologic correlation. South Med J. 1998;91(10):957–960.
  2. Capov I, Wechsler J, Pavlik M, et al. Rare incidence of pulmonary gangrene-algorithm of the treatment. Magy Seb. 2006;59(1):32–35.
  3. Kothari PR, Jiwane A, Kulkarni B. Pulmonary gangrene complicating bacterial pneumonia. Indian Pediatr. 2003; 40(8):784–785.
  4. Kalfa N, Allal H, Lopez M, et al. An early thoracoscopic approach in necrotizing pneumonia in children: a report of three cases. J. Laparoendosc. Adv. Surg. Tech. A. 2005;15(1):18–22.
  5. Kelly MV, Kyger ER, Miller WC. Postoperative lobar torsion and gangrene. Thorax. 1977;32:501–504.
  6. Haraszti A, Sovari M. Fatal pulmonary gangrene caused by inhalation of fuel oil. Orv Hetil. 1968;21(16):851–854.
  7. Vorobeva OV. Changes in organs in COVID-19 infection with septicopyemia. Profilakticheskaya meditsina. 2021;24(10):89-93. (In Russ). doi: 10.17116/profmed20212410189
  8. Vorobeva OV, Lastochkin AV. Organ-specific pathomorphological changes during COVID-19. Russian Journal of Infection and Immunity. 2020;10(3):587–590. (In Russ). doi: 10.15789/2220-7619-PCI-1483
  9. Abdelhadi A, Kassem A. Candida Pneumonia with Lung Abscess as a Complication of Severe COVID-19 Pneumonia. Int Med Case Rep J. 2021;14:853–861. doi: 10.2147/IMCRJ.S342054
  10. Zamani N, Aloosh O, Ahsant S, et al. Lung abscess as a complication of COVID-19 infection, a case report. Clin Case Rep. 2021;9(3):1130–1134. doi: 10.1002/ccr3.3686
  11. Renaud-Picard B, Gallais F, Riou M, et al. Delayed pulmonary abscess following COVID-19 pneumonia: A case report. Respir Med Res. 2020;78:100776. doi: 10.1016/j.resmer.2020.100776
  12. Nagy E, Maier T, Urban E, Terhes G, Kostrzewa M; ESCMID Study Group on Antimicrobial Resistance in Anaerobic Bacteria. Species identification of clinical isolates of Bacteroides by matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry. Clin Microbiol Infect. 2009;15(8):796–802. doi: 10.1111/j.1469-0691.2009.02788.x
  13. Wybo I, Soetens O, De Bel A, et al. Species identification of clinical Prevotella isolates by matrix-assisted laser-desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2012;50(4): 1415–1418. doi: 10.1128/JCM.06326-11
  14. Shilnikova II, Dmitrieva NV. Assessment of sensitivity to antibiotics of anaerobic pathogens Bacteroides, Prevotella and Fusobacterium isolated from cancer patients. Siberian Journal of Oncology. 2015;(5):37–43.
  15. Rennie RP, Turnbull L, Brosnikoff C, Cloke J. First comprehensive evaluation of the M.I.C. evaluator device compared to Etest and CLSI reference dilution methods for antimicrobial susceptibility testing of clinical strains of anaerobes and other fastidious bacterial species. J Clin Microbiol. 2012;50(4):1153-1157. doi: 10.1128/JCM.05397-11

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Microscopic picture of a decaying cavity with hemorrhages in the decay zone. Hematoxylin and eosin staining, ×900.

Download (913KB)
Indexing metadata
3. Fig. 2. Microscopic picture of diffuse destructive changes with hemorrhages. Staining with hematoxylin and eosin, ×900.

Download (917KB)
Indexing metadata

Copyright (c) 2023 Eco-vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80652 от 15.03.2021 . Учредитель ООО "Эко-Вектор Ай-Пи" (ОГРН 1157847215338).