Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneu
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(2020) 15:301
CASE REPORT
Open Access
Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report Vikisha Hazariwala*, Hind Hadid, Denise Kirsch and Cecilia Big
Abstract Background: Spontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia. The objective of this case presentation is to highlight an important complication and to explore potential predisposing risk factors and possible underlying pathophysiology of this phenomenon. Case presentation: We present two patients with COVID-19 pneumonia complicated by spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema without positive pressure ventilation. Both patients had multiple comorbidities, received a combination of antibiotics, steroids and supportive oxygen therapy, and underwent routine laboratory workup. Both patients then developed spontaneous pneumomediastinum and ultimately required intubation and mechanical ventilation, which proved to be challenging to manage. Conclusions: Spontaneous pneumomediastinum is a serious complication of COVID-19 pneumonia, of which clinicians should be aware. Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia. Keywords: COVID-19 pneumonia, Spontaneous pneumomediastinum, Spontaneous pneumopericardium, Acute respiratory distress syndrome, Severe acute respiratory syndrome
Background As the 2019 coronavirus pandemic unfolded globally, numerous reports of severe and unusual complications in infected patients have been published. Acute respiratory distress syndrome (ARDS) is a major and sometimes fatal complication observed in as many as 41% of hospitalized patients with COVID-19 [1]. Acute renal failure, cardiomyopathy, and thromboembolic phenomena were also observed in COVID-19 patients in varying severities and percentages [2, 3].
The following cases outline the clinical course of two patients with COVID-19 pneumonia who developed spontaneous pneumomediastinum (SPM), pneumopericardium (SPP), pneumothorax, and subcutaneous emphysema without positive pressure ventilation. These findings are extremely rare with only a few similar cases in English literature to date [4, 5].
Case presentation Patient 1
* Correspondence: [email protected] Beaumont Hospital, Dearborn, MI, USA
A 57-year-old Hispanic woman with asthma, hypertension and obesity (BMI 36 kg/m2) presented to the emergency
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the
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