Akeely Yahia Yaseen, Alesa Saleh, Hassan Hassan Gafar, Almarzouqi Sultan, Alchammat Mohamad Ziad, Elghor Omar, Patel Shabana Begum, Shaat Emad Hamdi
Emergency Medicine Department Security Forces Hospital Riyadh City Saudi Arabia.
Respirol Case Rep. 2024 Sep 16;12(9):e70025. doi: 10.1002/rcr2.70025. eCollection 2024 Sep.
An 18-year-old healthy male complained of a 7-day history of fever, cough, and sore throat, along with a three-day history of left facial swelling. The x-rays revealed subcutaneous emphysema in the chest, neck, face, and mediastinum region (Pneumomediastinum). Furthermore, an area of infiltration was visible, indicating pneumonia. Therefore, we immediately started him on intravenous antibiotics. We then moved the patient to an isolation room, considering pulmonary tuberculosis as one of the differential diagnoses. However, the Acid Fast Bacilli (AFB), Mycobacterium Tuberculosis Bacteria-Polymerase Chain Reaction (MTB PCR), and sputum for gram stain and culture were all negative. On the other hand, the test for parainfluenza virus 3 was positive. The patient was observed with a daily chest x-ray to monitor the progress of pneumonia and subcutaneous emphysema. Fortunately, the subcutaneous emphysema was significantly reduced on a daily basis until it was completely resolved before discharge home.
一名18岁健康男性主诉发热、咳嗽和咽痛7天,伴有左侧面部肿胀3天。X线显示胸部、颈部、面部及纵隔区域皮下气肿(纵隔气肿)。此外,可见一处浸润区域,提示肺炎。因此,我们立即给他静脉使用抗生素。鉴于肺结核是鉴别诊断之一,我们随后将患者转移至隔离病房。然而,抗酸杆菌(AFB)、结核分枝杆菌聚合酶链反应(MTB PCR)以及革兰氏染色和培养的痰液检测结果均为阴性。另一方面,副流感病毒3检测呈阳性。每天对患者进行胸部X线检查,以监测肺炎和皮下气肿的进展情况。幸运的是,皮下气肿每天都有明显减轻,直至出院前完全消退。