PMC7483079_01
CXR on Admission- Large left-sided tension pneumothorax and small right-sided pneumothorax.
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A bedside ultrasound demonstrated pneumothorax and a portable anterior/posterior chest x-ray (CXR) confirmed a large left-sided tension pneumothorax as well as a small right-sided pneumothorax (Fig. 1).
CT Chest on Admission- Extensive pneumomediastinum, pneumopericardium and bilateral pneumothoraces. Bilateral confluent parenchymal consolidations, compatible with multilobar pneumonia.
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Non-contrast chest CT was significant for extensive pneumomediastinum, pneumopericardium, and bilateral pneumothoraces, as well as bilateral confluent parenchymal consolidations, compatible with multilobar pneumonia (Fig. 2).
CXR from HD six- Small residual left-sided pneumothorax. Stable bilateral opacities.
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Over the following days, the patient's supplemental oxygen requirements decreased, and he was transferred to the medical floor on hospital day (HD) three with serial CXRs demonstrating gradual resolution of his pneumothoraces (Fig. 3).
CXR from ten days after initial presentation to ED- New bilateral pneumothoraces with 7-cm airgap on right and 4.5-cm airgap on left. Airspace opacities consistent with viral pneumonia.
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CXR revealed recurrent new bilateral pneumothoraces with an approximate 7-cm airgap on the right and an approximate 4.5-cm airgap on the left (Fig. 4).
CT Chest on HD five- Right posterior basilar loculated hydropneumothorax.
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A CT chest with IV contrast was obtained and demonstrated worsening bilateral basilar loculated hydropneumothorax (Fig. 5).
CXR from day of discharge (HD fifteen)- Stable mid/lower lung zone parenchymal opacities and pleural thickening. No pneumothorax.
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By HD fifteen, all chest tubes were removed and repeat CXR noted resolved pneumothoraces (Fig. 6).