Spontaneous pneumomediastinum in COVID-19 pneumonia: Two Cases and Review of the Literature

Year 2022, , 34 - 36, 08.03.2022

Hasan Kara , Aysegül Bayır , Selim Değirmenci , Hüseyin Yıldıran , Ahmet Ak

https://doi.org/10.33706/jemcr.1015741

Cited By: 1

Abstract

Introduction: Spontaneous pneumomediastinum (PM) is a rare presentation associated with Coronavirus disease 2019 (COVID-19). Here, we report two cases presented with spontaneous PM associated with COVID-19 pneumonia.
Case Reports:
Case 1: A 58-year-old female patient was admitted to the Emergency Department (ED) with dyspnea, hoarseness, myalgia, and cough. A chest CT scan revealed subcutaneous emphysema, diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. In critical intensive care, the patient developed multi-organ failure and expired on the 10th day.
Case 2: A 34-year-old male patient admitted to the ED with dyspnea and cough. A chest CT scan revealed diffuse PM, bilateral diffuse areas of ground-glass opacity, and consolidations. The patient was transferred to the critical care unit. His progress was uneventful and he was discharged after 12 days.
Conclusion: Patients suspected of PM should be examined closely during the differential diagnosis of chest pain, dyspnea, subcutaneous emphysema, and various lung- and heart-induced states. Patients diagnosed with spontaneous PM should be hospitalized for observation because the condition can be associated with complications, including death.

Keywords

COVID-19, Dyspnea, Pneumomediastinum, Complication

References

• 1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
• 2. Shan S, Guangming L, Wei L, Xuedong Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19: case report and literature review. Rev Inst Med Trop São Paulo 2020; 62: e76.
• 3. Janssen J, Kamps MJA, Joosten TMB, Barten DG. Spontaneous pneumomediastinum in a male adult with COVID-19 pneumonia. Am J Emerg Med 2020; 30: S0735-6757(20)30661-6.
• 4. Nieves-Ortiz AA, Fonseca-Ferrer V, Hernández-Moya K, Ramirez KM, Ayala-Rivera J, Delgado M. Spontaneous pneumomediastinum associated with COVID-19:Rare complication of 2020 pandemic. J Pulmonol Respir Res 2020; 4: 018-020.
• 5. Pal M, Berhanu G, Desalegn C, Kandi V. Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2): An Update. Cureus 2020; 12(3): e7423.
• 6. Zhou C, Gao C, Xie Y, Xu M. COVID-19 with spontaneous pneumomediastinum. Lancet Infect Dis 2020; 20(4): 510.
• 7. Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep 2020; 13: e236519.
• 8. Ucpinar BA, Sahin C, Yanc U. Spontaneous pneumothorax and subcutaneous emphysema in COVID-19 patient: case report. J Infect Public Health 2020; 13: 887-9.
• 9. Mansella G, Bingisser R, Nickel CH. Pneumomediastinum in blunt chest trauma: a case report and review of the literature. Case Rep Emerg Med 2014; 2014: 685381.
• 10. Brogna B, Bignardi E, Salvatore P, Alberigo M, Brogna C, Megliola A. Unusual presentations of COVID-19 pneumonia on CT scans with spontaneous pneumomediastinum and loculated pneumothorax: A report of two cases and a review of the literature. Heart Lung 2020; 49(6): 864-8.