Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 11 , ISSUE 4 ( October-December, 2022 ) > List of Articles

CASE REPORT

Airleak Syndrome Like Spontaneous Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax as Presenting Signs of Corona Virus Pneumonia - A Case Series

Sanjeev Kumar Singla, Rakendra Singh

Keywords : COVID-19, pneumothorax, spontaneous pneumomediastinum, subcutaneous emphysema

Citation Information : Singla SK, Singh R. Airleak Syndrome Like Spontaneous Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax as Presenting Signs of Corona Virus Pneumonia - A Case Series. Indian J Respir Care 2022; 11 (4):392-395.

DOI: 10.4103/ijrc.ijrc_124_22

License: CC BY-NC-SA 4.0

Published Online: 01-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Abstract

infection in patients without positive pressure ventilation. This case series presents five cases of COVID-19 pneumonia who presented with alveolar air leak syndrome without prior invasive or noninvasive ventilation and high-flow nasal cannula oxygenation. Two patients presented with surgical emphysema, two with pneumothorax, and one with pneumomediastinum. This series included 30-50-year-old nonsmokers (three males and two females) with no previous history of any comorbidity and smoking who came to the emergency with symptoms such as cough, breathing difficulty, and respiratory distress. The COVID-19 infection was diagnosed by reverse transcriptase-polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2. Chest X-ray and computed tomography showed diffuse multifocal ground-glass infiltrates, interlobular septal thickening, and infiltration in all patients. Three patients had subcutaneous emphysema, two had pneumothorax and pneumomediastinum, and one had pneumomediastinum. Three patients later on required invasive mechanical ventilation. Alveolar air leak syndrome including spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema is rarely seen as the initial presentation of coronavirus pneumonia but may develop after positive pressure ventilation.


HTML PDF Share
  1. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Geneva: World Health Organization; 2020. Available from: https://covid19.who.int/region/searo/country/in. [Last accessed on 2022 Jun 14].
  2. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020;180:934-43.
  3. Bejvan SM, Godwin JD. Pneumomediastinum: Old signs and new signs. AJR Am J Roentgenol 1996;166:1041-8.
  4. Sun R, Liu H, Wang X. Mediastinal emphysema, giant bulla, and pneumothorax developed during the course of COVID-19 pneumonia. Korean J Radiol 2020;21:541.
  5. Wintermark M, Schnyder P. The Macklin effect: A frequent etiology for pneumomediastinum in severe blunt chest trauma. Chest 2001;120:543-7.
  6. Chu CM, Leung YY, Hui JY, Hung IF, Chan VL, Leung WS, et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J 2004;23:802-4.
  7. Eperjesiova B, Hart E, Shokr M, Sinha P, Ferguson GT. Spontaneous pneumomediastinum/pneumothorax in patients with COVID-19. Cureus 2020;12:e8996.
  8. Miñambres E, Burón J, Ballesteros MA, Llorca J, Muñoz P, González-Castro A. Tracheal rupture after endotracheal intubation: A literature systematic review. Eur J Cardiothorac Surg 2009;35:1056-62.
  9. Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: Experience in 24 adult patients. Eur J Cardiothorac Surg 2004;25:852-5.
  10. Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X, et al. CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology 2020;295:202-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.