Bilateral pneumatoceles resulting in spontaneous bilateral pneumothoraces and secondary infection in a previously healthy man with COVID-19

An acute COVID-19 infection can result in cystic lung changes that have a unique presentation and are inherently difficult to manage with or without preexisting conditions. Even though reportedly very few COVID-19 patients develop secondary bacterial infections due to unclear mechanisms, a postviral sequela with typical and atypical organisms can prolong the course of lung damage. The long-term effects of COVID-19 lung damage are still unclear, as the morbidity of the disease process is yet to be fully understood. This report presents a rare complication of COVID pneumonia with bilateral necrotizing pneumatoceles presenting with hemoptysis and bilateral pneumothoraces with positive sputum cultures for Enterobacter aerogenes and Pseudomonas aeruginosa. It highlights rare complications of COVID-19 requiring multiple hospital admissions and ongoing home oxygen therapy.