Spontaneous pneumomediastinum as a complication of a COVID-19 related pneumonia: case report and review of literature

Abstract

A novel coronavirus, SARS-COV-2, related infection is thought to have originated in Wuhan, China, in November 2019 but spread rapidly to be declared a global pandemic by the WHO in March 2020. The patients typically present with fever and shortness of breath. We describe a case of spontaneous pneumomediastinum at presentation as a complication of severe Covid-19 infection. A 54 year old male patient with no history of smoking, asthma or other underlying chronic lung disease, presented to our emergency department with severe Covid-19 symptoms. His chest x-ray and CT scan on arrival at the emergency department, and prior to any intervention, demonstrated severe bilateral Covid-19 pneumonia complicated by a pneumomediastinum. The aetiology of the pneumomediastinum is thought to be a direct complication of severe covid-19 pneumonia in absence of any previous respiratory history or iatrogenic cause.

Keywords: CT Covid Complications; Covid-19; Covid-19 pulmonary complication; Pneumomediastinum.

Fig. 1

Chest X-Ray in AP erect view. Subcutaneous emphysema is noted in the supraclavicular area suggesting a pneumomediastinum.

Fig. 2

Transverse thin-section serial CT scans from a 54 year-old man. Subcutaneous emphysema noted within the right supraclavicular region and within the soft tissues of the neck extending from the mediastinum in keeping with pneumomediastinum.

Fig. 3

Coronal thin-section serial CT scans from a 54 year-old man. Subcutaneous emphysema noted within the right supraclavicular region and within the soft tissues of the neck extending from the mediastinum in keeping with pneumomediastinum.