• Emerg Med J · Jun 2006

    Case Reports

    Spontaneous pneumopericardium, pneumomediastinum and subcutaneous emphysema: unusual complications of asthma in a 2-year-old boy.

    • V Ameh, R Jenner, N Jilani, and A Bradbury.
    • Emergency Department, South Manchester University Hospital, Manchester, UK. amehyaks@yahoo.com
    • Emerg Med J. 2006 Jun 1; 23 (6): 466467466-7.

    AbstractA 2-year-old boy presented to the emergency department with a history of sudden onset of cough, dyspnoea and a slight expiratory wheeze on the right lung base. He also had subcutaneous emphysema on the left side of the chest anteriorly. Chest x ray confirmed subcutaneous emphysema and also revealed pneumomediastinum and pneumopericardium. He had had no previous episode and was not known to have asthma. He was apyrexial but had a raised white cell count. The eosinophil count was within normal limits. He was successfully treated with nebulised salbutamol, steroids, antibiotics and high flow oxygen. He made a good recovery and was discharged after 7 days. This case highlights the need for a high index of suspicion of asthma in very young children presenting for the first time with such complications.

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