A severe case of pneumomediastinum

Abstract

Pneumomediastinum is defined as the presence of air in the mediastinum. It can be spontaneous or secondary to several conditions as trauma, anatomic airway anomalies, respiratory infections, bronchiectasis or exacerbation of asthma, chronic obstructive pulmonary disease or interstitial lung disease (ILD). We present a case of 86-year-old male, hospital admitted for pneumonia, that developed an exuberant pneumomediastinum, with cervical and thoracic subcutaneous emphysema and bilateral pneumothorax. He had a previous chest computed tomography (CT) scan revealing fibrosing ILD, unknown before. A new chest-CT scan revealed features of ILD exacerbation. We observed rapid clinic deterioration, with circulatory chock, with progressive deterioration, leading to death.