Tata Ravichandra, Bingi Thrilok Chander, Maurya Akhilesh Kumar, Kalakuntla Hemanth, Gangishetti Saketh
General Medicine, Gandhi Hospital, Hyderabad, IND.
Cureus. 2021 Jun 30;13(6):e16051. doi: 10.7759/cureus.16051. eCollection 2021 Jun.
Subcutaneous emphysema (SE) and pneumomediastinum are rare complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While SE is often non-fatal and usually self-remitting, pneumomediastinum can be fatal with high mortality rates depending on the underlying etiology. Here, we present the case of a 39-year-old otherwise healthy male who tested positive for SARS-CoV-2. The patient was treated with non-invasive mechanical ventilation (NIMV) and developed severe SE and pneumomediastinum which resulted in a fatal outcome. Although the exact pathogenesis could not be determined, the extensive lung injury caused by SARS-CoV-2 pneumonia along with possible barotrauma secondary to NIMV could have been the culprits in this case. Early detection through careful observation of these potentially fatal complications in patients with severe coronavirus disease 2019 is crucial. Further studies determining the potential risk factors and incidence of SE and pneumomediastinum, especially in patients receiving invasive mechanical ventilation or NIMV, are needed.
皮下气肿（SE）和纵隔气肿是严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的罕见并发症。虽然皮下气肿通常不致命且往往可自行缓解，但纵隔气肿可能致命，其死亡率高低取决于潜在病因。在此，我们报告一例39岁的健康男性，其SARS-CoV-2检测呈阳性。该患者接受了无创机械通气（NIMV）治疗，随后出现严重皮下气肿和纵隔气肿，最终导致死亡。尽管确切发病机制尚无法确定，但SARS-CoV-2肺炎所致的广泛肺损伤以及无创机械通气可能继发的气压伤可能是该病例的罪魁祸首。对于患有严重2019冠状病毒病的患者，通过仔细观察这些潜在致命并发症进行早期检测至关重要。需要进一步开展研究，以确定皮下气肿和纵隔气肿的潜在危险因素及发生率，尤其是在接受有创机械通气或无创机械通气的患者中。
