A case of spontaneous pneumomediastinum in a patient with severe SARS-CoV-2 and a review of the literature.
A case of spontaneous pneumomediastinum in a patient with severe SARS-CoV-2 and a review of the literature.
复制标题
严重的SARS-COV-2患者和文献综述的患者中自发的气动症。
DOI：
10.1177/2050313x211010021
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发表时间：
2021
影响因子：
0.8
通讯作者：
Perez-Corral C
中科院分区：
文献类型：
--
作者：
Hua DT;Shah F;Perez-Corral C
自发性纵隔气肿定义为与手术、创伤或机械通气无关的病因。诱发自发性纵隔气肿的原因包括咳嗽、运动、呕吐、感染、潜在的肺部疾病，如哮喘和非法药物。症状包括胸痛、呼吸急促和吞咽困难。一位54岁男性患者出现两个 周的呼吸急促、咳嗽和发烧。他因严重的SARS-CoV-2肺炎和需要非呼吸机面罩的急性缺氧性呼吸衰竭而入院。入院时胸部影像显示双侧外周实变和纵隔气肿伴皮下气肿。未发现任何诱发事件。他在入院期间并不要求开始正压通气。入院第7天，胸部影像显示纵隔气肿和皮下气肿消退，他成功出院接受氧疗。自发性纵隔气肿是严重急性呼吸综合征冠状病毒2型感染的罕见并发症。自发性纵隔气肿通常是良性和自限的，只需要支持性治疗。
Spontaneous pneumomediastinum is defined as having an etiology that is not related to surgery, trauma, or mechanical ventilation. Precipitating causes of spontaneous pneumomediastinum include coughing, exercise, vomiting, infection, underlying lung diseases such as asthma, and illicit drugs. Symptoms include chest pain, shortness of breath, and dysphagia. A 54-year-old man presented with 2 weeks of shortness of breath, cough, and fever. He was admitted for severe SARS-CoV-2 pneumonia and acute hypoxic respiratory failure requiring non-rebreather mask. Chest imaging on admission showed bilateral peripheral consolidations and pneumomediastinum with subcutaneous emphysema. No precipitating event was identified. He did not require initiation of positive pressure ventilation throughout his admission. On hospital day 7, chest imaging showed resolution of pneumomediastinum and subcutaneous emphysema, and he was successfully discharged on oxygen therapy. Spontaneous pneumomediastinum is a rare complication of severe acute respiratory syndrome coronavirus 2 infection. Spontaneous pneumomediastinum is typically benign and self-limiting, requiring only supportive treatment.