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?:abstract
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This case report describes the clinical course and management of a 65-year-old man was admitted to the intensive care unit (ICU) of Tenon hospital, a university teaching hospital in Paris, France, for severe confirmed COVID-19 pneumonia Acute cavitary lung lesions are usually related to mycobacterial, parasitic, fungal, or bacterial infection, particularly Staphylococcus aureus, Pseudomonas aeruginosa, and other gram-negative bacilli In this case, despite VAP due to Citrobacter koseri and Achromobacter xylosoxidans, this hypothesis is unlikely because neither radiological changes nor signs of necrotizing pneumonia were present on successive chest x-rays Other causes of lung cavitation, such as autoimmune disorder or genetic mutations, were not investigated but the speed of the development of cavitary lesion in a few days was considered atypical In the last hypothesis, although interleukin 6 (IL-6) inhibitor-induced interstitial lung disease has already been described, cavitation related to tocilizumab has not been reported, thus it should be reported as a related side adverse event Severe COVID-19 pneumonia may progress to pulmonary fibrosis related to diffuse alveolar damage, but the association with lung cavitation is uncommon and may significantly impair the outcome
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