Pulmonary cavitation in COVID-19 pneumonia; is it primary or secondary?

A wide variety of chest computed tomography (CT) findings have been reported in patients with Covid-19 pneumonia. Pulmonary cavitation, although reported in a few cases of Covid19 pneumonia in the literature, is an uncommon finding to be identified in viral pneumonia and is considered among atypical CT features of Covid-19. In an attempt to adress to this issue, We want to emphasize the possibility of secondary infections in Covid-19, presenting with pulmonary cavitations as in our patient demonstrating a large sized pulmonary cavity when he was in intensive care unit (ICU).With consideration of a superinfection, bronchoscopy was performed and revealed growth of Acinetobacter in bronchoalveolar lavage (BAL) culture. As a result, secondary infections are common particularly in severely ill Covid-19 patients with much greater frequency in ICU. In cases of cavitary lesions superinfection should always be considered and accurate targetted treatment according to susceptibility testing should be started immediatelly, for better clinical outcomes.