• Angela Basnet, Sabin Chaulagain, Ashok Thapa, Manita Khadka, Manoj Khadka, and Dhan Bahadur Shrestha.
• Department of Internal Medicine, Scheer Memorial Adventist Hospital, Banepa, Kavrepalanchok, Nepal.
• JNMA J Nepal Med Assoc. 2021 Dec 11; 59 (244): 1313-1315.

AbstractAfter almost a year of declaring COVID-19 a global pandemic, unusual presentations of the disease continue to be reported. Very little is known about its association with pleural disease. Here, we present a case of empyema thoracis in a 39-year-old male admitted with COVID-19. The pleural fluid later turned serosanguinous and eventually bleeding from other sites also occurred. During his treatment, antibiotics were given, thoracocentesis was performed and later thoracotomy was done. He died on the 19th day of admission following a hemorrhagic stroke. Pleural disease, although considered atypical and unusual presentation of COVID-19, needs careful and prompt diagnosis and earliest intervention. COVID-19, being a disease that involves multiple systems, and presentation of the disease may eventually lead to circulatory dysfunction and hence should be kept under consideration.

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