Acinetobacter superinfection in elderly COVID-19 patients with pneumothorax - a report of two cases

Introduction. Coronavirus disease 2019 is an infectious disease that primarily affects the lungs. Since the pandemic of severe acute respiratory syndrome coronavirus 2 continues and a large number of cases are registered worldwide, the knowledge about the virus and virus-related complications is growing as well. Pleural complications, pneumothorax, and empyema are important issues affecting better patient survival. Bacterial superinfections may cause complications of coronavirus disease 2019. Knowledge about the incidence of superinfections, microbiological causes, treatment, and outcomes of the disease is incomplete. Case Report. We present two oxygen-dependent patients with coronavirus disease 2019 who developed pneumothorax and empyema during hospitalization, three weeks after the onset of coronavirus disease 2019 symptoms. Multidrug-resistant Acinetobacter spp. was isolated from the thoracic drain. Conclusion. Pneumothorax may occur at any stage of coronavirus disease 2019 and is not always associated with the severity of viral infection. Empyema due to coronavirus disease 2019 pneumonia is rare and occurs as a superinfection of the pleural effusion. Excessive use of antibiotics in the treatment of hospitalized patients with coronavirus disease 2019 may increase the risk of nosocomial infections caused by multidrug-resistant bacteria.