Edwards Michael, Ramappa Arun Jeenahalli
Foundation Year 2 Doctor, Aintree University Hospital, Liverpool, UK.
Acute Medicine Consultant, Aintree University Hospital, Liverpool, UK.
Eur J Case Rep Intern Med. 2017 Feb 3;4(4):000549. doi: 10.12890/2017_000549. eCollection 2017.
A 79-year-old gentleman presented with spontaneous pneumomediastinum and subcutaneous emphysema with pneumonia but no pre-existing lung disease. He presented with a 4-day history of increased shortness of breath, pleuritic chest pain, fevers, and non-productive cough. After 4 days of intravenous antibiotics, the patient developed considerable subcutaneous emphysema and pneumomediastinum. Pneumomediastinum presents most commonly with chest pain, shortness of breath, and subcutaneous emphysema. It has previously been associated with cases of pneumonia but often with rare strains such as pneumonia in immunocompromised patients. This case highlights spontaneous pneumomediastinum as a rare complication of pneumonia. Treatment of pneumomediastinum is typically conservative, and although options may be limited, aggressive management of any causative factor may be essential in selected cases.
Pneumomediastinum and subcutaneous emphysema are rare complications of pneumonia.Computerised tomography is a valuable diagnostic tool for identifying pneumomediastinum in patients with subcutaneous emphysema.While pneumomediastinum is typically a benign condition, aggressive management may occasionally be required. Evidence regarding use of non-invasive/invasive ventilation remains limited but it may theoretically aggravate any air leakage.
一名79岁男性患者出现自发性纵隔气肿和皮下气肿并伴有肺炎，但既往无肺部疾病。他有4天的气短加重、胸膜炎性胸痛、发热和干咳病史。静脉使用抗生素4天后，患者出现了大量皮下气肿和纵隔气肿。纵隔气肿最常见的表现为胸痛、气短和皮下气肿。此前它曾与肺炎病例相关，但通常与免疫功能低下患者中的罕见菌株如肺炎有关。该病例突出了自发性纵隔气肿作为肺炎罕见并发症的情况。纵隔气肿的治疗通常是保守的，虽然选择可能有限，但在某些病例中积极处理任何致病因素可能至关重要。
纵隔气肿和皮下气肿是肺炎的罕见并发症。计算机断层扫描是识别皮下气肿患者纵隔气肿的有价值的诊断工具。虽然纵隔气肿通常是一种良性疾病，但偶尔可能需要积极处理。关于使用无创/有创通气的证据仍然有限，但理论上它可能会加重任何漏气情况。
