Lung function improvements in emphysema following pneumonia

Abstract

We describe two cases of patients with emphysema who, in the lead up to hyperinflation intervention, developed pneumonia with significant physiological, anatomical, functional and quality of life improvement observed following. This directly goes against the natural history of both disease processes, demonstrating the benefit resulting from infective autobullectomy.

Autobullectomy with COVID-19 in a patient with chronic obstructive pulmonary disease

“…Autobullectomy occurs rarely and is primarily due to bacterial infection. After autobullectomy, shrinkage of the bulla is observed on chest radiography or CT, with improvement in pulmonary function tests [ [4] , [5] , [6] ]. Despite the pandemic, to date, there have been only a few reports of autobullectomy caused by COVID-19 [ 7 ].…”

“…The pathophysiology of autobullectomy associated with bacterial pneumonia has also been inferred. When bacterial infections occur in the lungs, inflammation is evoked, leading to connective tissue deposition in the lung parenchyma [ 5 , 8 ]. Around emphysematous tissue, the fibrosing process may result in emphysema shrinkage [ 5 ].…”

“…When bacterial infections occur in the lungs, inflammation is evoked, leading to connective tissue deposition in the lung parenchyma [ 5 , 8 ]. Around emphysematous tissue, the fibrosing process may result in emphysema shrinkage [ 5 ]. It may result from inflammation in the airways, obstructing air supply to the bulla [ 4 , 6 , 7 , 9 ].…”

“…“Autobullectomy” is a rare phenomenon in which large bullas shrink, often following bacterial pneumonia, and pulmonary function eventually improves [ [4] , [5] , [6] ]. Here, we report a rare case of autobullectomy caused by coronavirus disease 2019 (COVID-19) in a patient with COPD, with analysis of lung function tests and computed tomography (CT) images pre- and post-infection.…”

Bronchoscopic Lung Volume Reduction Using Coil Therapy: Complications and Management

“…In a different report of two patients with severe upper lobe emphysema, the study subjects were treated for community-acquired upper lobe pneumonia [41]. After pneumonia treatment and resolution, the most diseased and hyperinflated lung area lost lobar volume and significant improvement in respiratory function was reported.…”