Table of Contents

HK J Paediatr (New Series)
Vol 22. No. 4, 2017

HK J Paediatr (New Series) 2017;22:229-231

Case Report

Spontaneous Pneumomediastinum in Rhinovirus Infection
鼻病毒感染中的自發性縱膈氣腫

EA Berksoy, T Özkul, ÖB Soylu


Abstract

Background: Spontaneous pneumomediastinum (SPM), a spontaneous mediastinal air-leak without any trauma or mechanical ventilation, is a rare paediatric emergency that typically occurs secondary to asthma attack in children. Herein, we report a case of SPM with subcutaneous emphysema in a 3-year-old child following rhinovirus (RV) infection. Case: A 3-year-old male patient was referred from another medical centre when respiratory distress, tachypnoea, and wheezing developed in addition to an ongoing cough and runny nose. It was the first wheezy attack and there was no history of atopy and no allergic diseases, foreign body aspiration, or trauma. Upon examination of the patient, who was admitted to emergency services, there were no pathological findings except for respiratory distress, common crepitations in the bilateral neck and chest walls, and bilateral wheezing during the respiratory system examination. Chest radiograph findings were compatible with pneumomediastinum and RV was detected in his nasal swab sample based on multiplex polymerase chain reaction methods. The patient improved spontaneously with conservative treatment. Conclusions: RV infections in children can lead to serious, life-threatening complications such as pneumomediastinum without pneumothorax. Thus, it should be considered a triggering agent of SPM in children even without a history of asthma.

背景:自發性縱膈氣腫(SPM)指在沒有任何創傷和機械通氣下,自發性的縱膈空氣洩露。此乃一種少見的兒童急症,典型病例繼發於兒童哮喘發作。特此,作者報告一例3歲兒童鼻病毒感染後出現SPM伴皮下氣腫。病例:1名3歲男童由外院轉介,當時有呼吸窘迫、呼吸短促、喘息發作、持續咳嗽和流涕。此為首次喘息發作,無濕疹和過敏性疾病史,無異物吸入史,無外傷史。送入急症室後檢查結果,除呼吸系統檢查發現呼吸窘迫、雙側頸部和胸壁普通囉音、和雙側喘息外,無其他病理生理學發現。胸部X-光片發現縱膈氣腫,用巢式PCR方法從鼻拭子監測到鼻病毒。經保守治療後,病人自行好轉。結論:兒童鼻病毒感染可導致嚴重致命性併發症,如無氣胸的縱膈氣腫。因此,儘管病童沒有哮喘歷史,此鼻病毒可視作病童SPM的觸發病原。

Keyword : Child; Pneumomediastinum; Rhinovirus

關鍵詞:兒童、縱膈氣腫、鼻病毒

 
 

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