Pneumomediastinum associated to asthma exacerbation in adults: Two case reports and bibliographic review

Abstract

Introduction: Pneumomediastinum (PM) is defined as the presence of air in the mediastinal cavity. It has been initially described by Laennec in 1819 as secondary to trauma. Among the non-traumatic causes, asthma exacerbations are included. The following report depicts two PM cases in the context of an asthma exacerbation. Case 1: 18-year-old male, diagnosed with asthma since childhood. The patient presented with an asthma exacerbation, associated with subcutaneous emphysema and PM as a complication. Case 2: 37-year-old male, asthmatic athlete. He presented with an asthma exacerbation, associated with Salmonella bacteremia and PM as a tomographic finding. Conclusion: The real incidence of PM associated with asthma attacks is currently unknown. It is generally an asymptomatic and self-limited entity, but it must be suspected in patients presenting with dyspnea, subcutaneous emphysema and hypoxemia that does not improve with oxygen therapy. Controlling asthma exacerbation and monitoring the patient are the main bases of the treatment.

Keywords: Pneumomediastinum, asthma, air leak syndromes, subcutaneous emphysema, hypoxemia, chest Computed Tomography scan, Macklin effect.

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