E-mail this Article (login required)
E-mail the Author (login required)
Post a Comment (login required)
An Uncommon Cause of Spontaneous Pneumomediastinum and Subcutaneous Emphysema
Michael Edwards, Arun Jeenahalli Ramappa
European Journal of Case Reports in Internal Medicine - © EFIM


A 79-year-old gentleman presented with spontaneous pneumomediastinum and subcutaneous emphysema with pneumonia but no pre-existing lung disease.
He presented with a 4-day history of increased shortness of breath, pleuritic chest pain, fevers, and non-productive cough. After 4 days of intravenous antibiotics, the patient developed considerable subcutaneous emphysema and pneumomediastinum.
Pneumomediastinum presents most commonly with chest pain, shortness of breath, and subcutaneous emphysema. It has previously been associated with cases of pneumonia but often with rare strains such as P. jirovecii pneumonia in immunocompromised patients. This case highlights spontaneous pneumomediastinum as a rare complication of pneumonia.
Treatment of pneumomediastinum is typically conservative, and although options may be limited, aggressive management of any causative factor may be essential in selected cases.


pneumomediastinum; subcutaneous emphysema; pneumonia

  1. Kaji Y et al. Pneumomediastinum in a patient with pneumocystis jirovecii pneumonia. Intern Med 2012;51:2251.
  2. Mondello B, Pavia R, Ruggeri P et al. Spontaneous pneumomediastinum: experience in 18 adult patients. Lung 2007;185:9–14.
  3. Macia I, Moya J, Ramos R et al. Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg 2007;31:1110-4.
  4. Kouritas VK, Papagiannopoulos K, Lazaridis G et al. Pneumomediastinum. J Thorac Dis 2015;7: S44–S49.
  5. Chu CM, Leung YY, Hui JY et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J 2004;23:802-4.

© EFIM Copyright 2016