Pneumomediastinum: a rare complication in COVID-19 patients
Keywords:
Pneumomediastinum, Pneumothorax, COVID-19, Computed tomography, X-ray, SARSCOV-2Abstract
A 62-year-old man with COVID-19 had PS for fever, coughing, and breathlessness. Two days after therapy, the patient’s clinical condition worsened. X-ray and CT showed pneumomediastinum, emphysema and pneumothorax. The patient was intubated and subjected to conservative therapy. The patient was discharged after about 20 days.
Radiological imaging plays a key role in the proper diagnosis and treatment of COVID-19 patients with related complications.
References
World Health Organization. WHO Director-General’s remarks at the media briefing on 2019-nCoV on11 February 2020.
Wu C, Chen X, Cai Y, et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020 Jul 1;180(7):934-943. Erratum in: JAMA Intern Med. 2020 Jul 1;180(7):1031.
Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust 2020;213:54–6.
Urigo C, Soin S, Sahu A. Spontaneous pneumomediastinum as a complication of a COVID-19 related pneumonia: case report and review of literature. Radiol Case Rep 2020;15(12):2577–81.
Kalpaxi A, Kalokairinou M, Katseli P, et al. Spontaneous pneumomediastinum and COVID-19 pneumonia: Report of three cases with emphasis on CT imaging. Radiol Case Rep. 2021 Sep;16(9):2586-2592. Epub 2021 Jun 23.
Macklin MT ,Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: interpretation of the clinical literature in the light of laboratory experiment. Medicine 1944;23:281–358.
Iqbal N, Malik A, Chaudhry M. The Macklin Effect in COVID-19. Cureus. 2021 Aug 6;13(8):e16949.
Jougon JB, Ballester M, Delcambre F, et al. Assessment of spontaneous pneumomediastinum: experience with 12 patients. Ann Thorac Surg 2003;75:1711–4.
Agut A, Talavera J, Buendia A, et al. Imaging diagnosis-spontaneous pneumomediastinum secondary to primary pulmonary pathology in a dalmatian dog. Vet Radiol Ultrasound 2015;56:E54–7.
Park DR, Vallières E. Pneumomediastinum and mediastinitis. In: Mason JR, Murray JF, Broaddus VC, Nadel JA, editors. Murray and Nadel’s Textbook of Respiratory Medicine Online, 4th edition. Elsevier Saunders, 2005; 2039–48.
Prompetchara E, Ketloy C, Palaga T. Immune responses in COVID-19 and potential vaccines: lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol 2020;38:1–9.
Brogna B, Brogna C, Martino A, et al. SARS-CoV-2 infection with different radiological insights. Diagnostics 2020;10:283.
Fox SE, Akmatbekov A, Harbert JL, et al. Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from new Orleans. Lancet Respir Med 2020;8:681–6.
Cut TG, Tudoran C, Lazureanu VE, Marinescu AR, Dumache R, Tudoran M. Spontaneous pneumomediastinum, pneumothorax, pneumopericardium and subcutaneous emphysema-not so uncommon complications in patients with COVID-19 pulmonary infection-a series of cases. J Clin Med 2021;10(7):1346.
Ozsoy IE, Tezcan MA, Guzeldag S, Ozdemir AT. Is spontaneous pneumomediastinum a poor prognostic factor in Covid-19? J Coll Physicians Surg Pak 2021;31(2):132–7.
Eperjesiova B, Hart E, Shokr M, Sinha P, Ferguson GT. Spontaneous pneumomediastinum/pneumothorax in patients with COVID-19. Cureus 2020;12(7):e8996.
Vázquez JL, Vázquez I, González ML, et al. Pneumomediastinum and pneumothorax as presenting signs in severe Mycoplasma pneumoniae pneumonia. Pediatr Radiol 2007;37:1286–8.
Vanzo V, Bugin S, Snijders D, et al. Pneumomediastinum and pneumopericardium in an 11-year-old rugby player: a case report. J Athl Train 2013;48:277–81.
Allen CJ, Teisch LF, Stahl KD. Spontaneous pneumomediastinum, pneumopericardium and epidural pneumatosis: insights on clinical management. Acute Card Care 2015;17:20–3.
Belotti EA, Rizzi M, Rodoni-Cassis P, et al. Air within the spinal canal in spontaneous pneumomediastinum. Chest 2010;137:1197–200.
Iyer VN, Joshi AY, Ryu JH. Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients. Mayo Clin Proc 2009;84:417–21
Elhakim TS, Abdul HS, Pelaez Romero C, Rodriguez-Fuentes Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. BMJ Case Rep 2020;13(12):e239489.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Francesco Saverio Guerra, Roberta Piccarreta, Rossella Carpentiere, Annalori Panunzio, Giuseppe Guglielmi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
