Persistent pneumomediastinum in interstitial fibrosis associated with rheumatoid arthritis: treatment with high-concentration oxygen.
We present a case of persistent spontaneous pneumomediastinum precipitated by an upper respiratory infection in a patient with interstitial fibrosis associated with rheumatoid arthritis who was receiving chronic corticosteroid treatment. The persistent nature of the mediastinal emphysema over 2 months eventually required treatment with high concentrations of inhaled oxygen that resulted in rapid resolution of the pneumomediastinum without recurrence over 6 months of follow-up. This case, along with others in the medical literature, emphasizes the need for early use of high-concentration inhaled oxygen in the treatment of pneumomediastinum in high-risk patients, such as those with connective tissue disorders.
Patel
A
A
Johns Hopkins University, School of Medicine at the Johns Hopkins Asthma and Allergy Center, Division of Pulmonary and Critical Care Medicine, Baltimore, MD 21224, USA.
Kesler
B
B
Wise
R A
RA
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000628:therapy*; D010102:Oxygen Inhalation Therapy; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000628:therapy*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed