Spontaneous pneumopericardium, pneumomediastinum and subcutaneous emphysema: unusual complications of asthma in a 2-year-old boy.
A 2-year-old boy presented to the emergency department with a history of sudden onset of cough, dyspnoea and a slight expiratory wheeze on the right lung base. He also had subcutaneous emphysema on the left side of the chest anteriorly. Chest x ray confirmed subcutaneous emphysema and also revealed pneumomediastinum and pneumopericardium. He had had no previous episode and was not known to have asthma. He was apyrexial but had a raised white cell count. The eosinophil count was within normal limits. He was successfully treated with nebulised salbutamol, steroids, antibiotics and high flow oxygen. He made a good recovery and was discharged after 7 days. This case highlights the need for a high index of suspicion of asthma in very young children presenting for the first time with such complications.
Ameh
V
V
Emergency Department, South Manchester University Hospital, Manchester, UK. amehyaks@yahoo.com
Jenner
R
R
Jilani
N
N
Bradbury
A
A
D000420:Albuterol / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications* / Q000188:drug therapy; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology* / Q000628:therapy; D010102:Oxygen Inhalation Therapy; D011026:Pneumopericardium / Q000209:etiology* / Q000628:therapy; D013256:Steroids / Q000627:therapeutic use; D013352:Subcutaneous Emphysema / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents; D000900:Anti-Bacterial Agents; D013256:Steroids; D000420:Albuterol