{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T09:15:00Z","timestamp":1764494100393,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,7,22]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>The COVID-19 pandemic has had a significant impact on the structure and operation of healthcare services worldwide. We highlight a case of a 64-year-old man who presented to the emergency department with acute dyspnoea on a background of a 2-week history of fever, dry cough and shortness of breath. On initial assessment the patient was hypoxic (arterial oxygen saturation (SaO<jats:sub>2<\/jats:sub>) of 86% on room air), requiring 10\u2009L\/min of oxygen to maintain 98% SaO<jats:sub>2<\/jats:sub>. Examination demonstrated left-sided tracheal deviation and absent breath sounds in the right lung field on auscultation. A chest radiograph revealed a large right-sided tension pneumothorax which was treated with needle thoracocentesis and a definitive chest drain. A CT pulmonary angiogram demonstrated segmental left lower lobe acute pulmonary emboli, significant generalised COVID-19 parenchymal features, surgical emphysema and an iatrogenic pneumatocoele. This case emphasises the importance of considering coexisting alternative diagnoses in patients who present with suspected COVID-19.<\/jats:p>","DOI":"10.1136\/bcr-2020-237475","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T08:42:27Z","timestamp":1597135347000},"page":"e237475","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Spontaneous tension pneumothorax and acute pulmonary emboli in a patient with COVID-19 infection"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6987-6698","authenticated-orcid":false,"given":"Ruhaid","family":"Khurram","sequence":"first","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin T F","family":"Johnson","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Revati","family":"Naran","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samanjit","family":"Hare","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"unstructured":"World health organisation coronavirus disease (COVID-19) Dashboard.","key":"2025082712551657000_13.8.e237475.1"},{"key":"2025082712551657000_13.8.e237475.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-235861","article-title":"Tension pneumothorax in a patient with COVID-19","volume":"13","author":"Flower","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2025082712551657000_13.8.e237475.3","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jiph.2020.05.012","article-title":"Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: case report","volume":"13","author":"Ucpinar","year":"2020","journal-title":"J Infect Public Health"},{"key":"2025082712551657000_13.8.e237475.4","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-236519","article-title":"Spontaneous pneumomediastinum in COVID-19","volume":"13","author":"Mohan","year":"2020","journal-title":"BMJ Case Rep"},{"doi-asserted-by":"publisher","key":"2025082712551657000_13.8.e237475.5","DOI":"10.1016\/S1473-3099(20)30156-0"},{"key":"2025082712551657000_13.8.e237475.6","doi-asserted-by":"crossref","DOI":"10.1007\/s00134-020-06078-3","article-title":"SARS-CoV-2 pulmonary infection revealed by subcutaneous emphysema and pneumomediastinum","author":"Lacroix","year":"2020","journal-title":"Intensive Care Med"},{"key":"2025082712551657000_13.8.e237475.7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000020175","article-title":"COVID-19 with cystic features on computed tomography: a case report","volume":"99","author":"Liu","year":"2020","journal-title":"Medicine"},{"key":"2025082712551657000_13.8.e237475.8","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s11239-020-02160-1","article-title":"Acute pulmonary embolism in COVID-19 related hypercoagulability","volume":"50","author":"Lorenzo","year":"2020","journal-title":"J Thromb Thrombolysis"},{"doi-asserted-by":"crossref","unstructured":"H\u00e9kimian G , Lebreton G , Br\u00e9chot N , et al . 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Chest CT Findings in Cases from the Cruise Ship \u201cDiamond Princess\u201d with Coronavirus Disease 2019 (COVID-19). 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