纵隔气肿(PM)和皮下气肿的特征是纵隔和皮下组织内的肺泡外空气。PM可自发发生或由于创伤或潜在的气道疾病而发生。自发性纵隔气肿(SPM)可能是由顽固性呕吐引起的,强烈的咳嗽,孩子出生,或者进行Valsalva演习.然而,目前存在甲型流感感染和电子烟(电子烟)诱导的SPM的组合的研究或病例报告有限。本病例报告介绍了一名先前健康的20岁女性的SPM,该女性患有未经治疗的甲型流感感染,并有使用电子烟的病史,并因发烧而向急诊科就诊。咳嗽,胸痛,呼吸困难,和呕吐。她的身体检查对颈部压痛有重要意义,皮下颈部疼痛,和增加呼吸的努力。诊断评估包括胸部X射线和胸部计算机断层扫描,显示PM伴有皮下气肿延伸到颈部,以及一项阴性的胃grafin研究。她接受了保守治疗,两天后出院,在肺部诊所进行随访。这份病例报告强调了详细的药物使用史的必要性,特别是电子烟的使用,在确定先前健康患者的SPM病因时。SPM的管理是保守的,应包括解决潜在的病因,并特别注意电子烟和非法物质的停止和教育。
Pneumomediastinum (PM) and subcutaneous emphysema are characterized by extra-alveolar air within the mediastinum and subcutaneous tissue. PM may occur spontaneously or due to trauma or an underlying airway disease. Spontaneous pneumomediastinum (SPM) may be caused by intractable vomiting, forceful coughing, child birthing, or performing a Valsalva maneuver. However, there are limited studies or case reports that present a combination of influenza A infection and electronic cigarette (e-cigarette)-induced SPM. This case report presents SPM in a previously healthy 20-year-old female with untreated influenza A infection and a history of e-cigarette use who presented to the emergency department with fever, cough, chest pain, dyspnea, and vomiting. Her physical examination was significant for neck tenderness, subcutaneous neck crepitus, and increased respiratory effort. Diagnostic evaluation included a chest X-ray and chest computed tomography that revealed PM with subcutaneous emphysema extending into the neck, as well as a negative Gastrografin study. She was treated conservatively and discharged after two days, with a follow-up scheduled at a pulmonary clinic. This case report highlights the need for a detailed substance use history, particularly e-cigarette use, when determining the etiology of SPM in a previously healthy patient. Management for SPM is conservative and should include addressing underlying etiologies with special attention to cessation and education of e-cigarettes and illicit substances.