Korean J Crit Care Med.  2010 Sep;25(3):155-158. 10.4266/kjccm.2010.25.3.155.

Spontaneous Pneumomediastinum and Subcutaneous Emphysema in Children Infected with H1N1 Virus: A Case Report

• Choi BG
• Yun HJ
• Kim YH
• Hyun MC

• KMID: 2228199
• DOI: http://doi.org/10.4266/kjccm.2010.25.3.155

Abstract

Spontaneous pneumomediastinum (SPM) is a rare condition in children which is triggered by respiratory infection and inflammation, although it occurs most commonly in asthmatics. It is caused by alveolar rupture and dissection of air into the mediastinum and hilum, and the prognosis is usually benign. We report two cases of SPM and subcutaneous emphysema complicating pneumonia in children with severe H1N1 infection. The patients were admitted to the intensive care unit and treated with oxygen, inhalation of a bronchodilator, intravenous systemic corticosteroid (methyprednisolone, 2 mg/kg/day for 5 days) and antibiotics, together with antiviral therapy. On day 4 after admission, there was no further evidence of SPM. SPM associated with severe H1N1 infection in children resolves with aggressive supportive care, without progression to pneumothorax. We should remain aware of this air leak complication in children with severe respiratory infection.

Keyword

child; emphysema; influenza; pneumomediastinum

MeSH Terms

Anti-Bacterial Agents
Child
Emphysema
Humans
Inflammation
Influenza, Human
Inhalation
Intensive Care Units
Mediastinal Emphysema
Mediastinum
Oxygen
Pneumonia
Pneumothorax
Prognosis
Rupture
Subcutaneous Emphysema
Anti-Bacterial Agents
Oxygen