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Case Reports
. 2019 May 26;13(1):157.
doi: 10.1186/s13256-019-2076-x.

Subcutaneous emphysema and pneumomediastinum in child with asthma revealing occult foreign body aspiration: a case report

Mounir Bourrous  1 , Widad Lahmini  2 , Hassan Nouri  3 , Nouzha Haimeur  4
Affiliations
Case Reports

Subcutaneous emphysema and pneumomediastinum in child with asthma revealing occult foreign body aspiration: a case report

Mounir Bourrous et al. J Med Case Rep. .

Abstract

Background: Exacerbations of asthma constitute the most common cause of pneumomediastinum and subcutaneous emphysema in children. Foreign body aspiration is a rare cause of pneumomediastinum and subcutaneous emphysema. Foreign body aspiration leading to the occurrence of pneumomediastinum in a child with asthma may go unnoticed and be wrongly attributed to asthma, which leads to delayed diagnosis as well as to life-threatening and long-term complications.

Case presentation: We describe a case of a 6-year-old Moroccan boy with asthma who was admitted to our emergency department for acute dyspnea and persistent dry cough. The patient was initially treated as having acute asthma exacerbation. Owing to insufficient clinical and radiographic improvement with asthma treatment, a rigid bronchoscopy under general anesthesia was performed. A pumpkin seed was removed from the left main bronchus. Clinical and radiographic improvement was achieved after foreign body extraction.

Conclusions: This case emphasizes that the possibility of foreign body aspiration should always and carefully be considered by the emergency physician when faced with a child with asthma presenting with pneumomediastinum and subcutaneous emphysema as an important differential diagnosis even in the absence of a history of foreign body aspiration.

Keywords: Child; Foreign body aspiration; Pneumomediastinum; Subcutaneous emphysema.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Radiograph of the chest showing subcutaneous emphysema (white arrows) and pneumomediastinum (black arrow), right basal pneumonia, and bilateral hyperinflation of the lung
Fig. 2
Fig. 2
Foreign body (pumpkin seed) removed
See this image and copyright information in PMC

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