Images in clinical medicine | Volume 37, Article 21, 05 Sep 2020 | 10.11604/pamj.2020.37.21.25311

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

Poobalan Naidoo, Yeshkhir Naidoo

Corresponding author: Poobalan Naidoo, Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa

Received: 02 Aug 2020 - Accepted: 11 Aug 2020 - Published: 05 Sep 2020

Domain: Infectious disease,Intensive care medicine,Internal medicine

Keywords: COVID-19, pleuro-peritoneal leak, Acinetobacter baumannii

©Poobalan Naidoo et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Poobalan Naidoo et al. COVID-19, gram-negative sepsis and a pleuro-peritoneal leak. Pan African Medical Journal. 2020;37:21. [doi: 10.11604/pamj.2020.37.21.25311]

Available online at: https://www.panafrican-med-journal.com/content/article/37/21/full

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Images in clinical medicine

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

Poobalan Naidoo1,&, Yeshkhir Naidoo2

 

1Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa, 2Department of Radiology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa

 

 

&Corresponding author
Poobalan Naidoo, Department of Nephrology, Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal, South Africa

 

 

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A 28-year old male with end stage renal disease, on continuous ambulatory peritoneal dialysis, presented with severe chest pain and dyspnoea at rest. Chest X-ray showed bilateral pleural effusions and when tapped had a high glucose concentration, suggesting a pleuro-peritoneal leak. Bilateral pleuro-peritoneal leaks were confirmed on nuclear medicine imaging. While awaiting pleurodesis he had another episode of severe chest pain. Chest X-ray showed a right sided pleural effusion with a vague opacity in the left upper zone. The pain resolved after parenteral opiate therapy and an acute coronary syndrome and pulmonary embolism were excluded. However, 18 hours later, he developed respiratory distress with type 1 respiratory failure. A repeat chest X-ray showed a circular opacification in the left upper zone. He was intubated, ventilated and a right sided chest drain inserted. He tested SARS-CoV-2 positive, and blood culture grew Acinetobacter baumannii. He demised post cardiopulmonary arrest.

 

Figure 1: A) right sided pleural effusion; B) right sided pleural effusion with vague opacification in the left upper zone; C) right sided pleural effusion with circular opacification in the left upper zone; D) right sided intercostal chest drain tube with left upper zone consolidation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

Images in clinical medicine

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

Images in clinical medicine

COVID-19, gram-negative sepsis and a pleuro-peritoneal leak

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Key words

COVID-19

Pleuro-peritoneal leak

Acinetobacter baumannii

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COVID-19, gram-negative sepsis and a pleuro-peritoneal leak