Abstract
We report on two cases of spontaneous pneumomediastinum and pneumopericardium, in one case associated with pneumorrhachis, occurring in two children suffering from the novel influenza H1N1 virus infection. At the admission both children presented with fever, violent dry cough, dyspnea and tachypnea. Radiological studies showed sizeable pneumomediastinum and pneumopericardium in both patients. One of the patients also a pneumorrachis. Children were initially treated by intravenous broad-spectrum antibiotics, antipyretics and a cough sedative. Oral Oseltamivir (60 mg twice daily for 5 days) was administered after the diagnosis of influenza A (H1N1) virus infection. Patients’ clinical condition quickly improved and children were discharged with a partial resolution of their radiological findings. Although these conditions are usually self-limiting and without respiratory or systemic consequences, their prompt recognition in children with H1N1 influenza virus infection is essential to establish fast and adequate therapy mainly related to the control of cough and the commencement of antiviral treatment.
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References
Garten RJ, Davis CT, Russell CA, et al., Antigenic and genetic characteristics of swine-origin 2009 A (H1N1) influenza viruses circulating in humans. Science 2009; 325, 197–201
Hasegawa M, Hashimoto K, Morozumi M et al., Spontaneous pneumomediastinum complicating pneumonia in children infected with 2009 pandemic influenza A (H1N1) v virus. Clin Microbiol Infect 2010;16, 195–199
Thompson WW, Shay DK, Weintraub E, et al., Influenza-associated hospitalizations in the United States. JAMA 2004; 292, 1333–1340
Centers for Disease Control. Hospitalized patients with novel influenza A (H1N1) virus infection-California, April–May 2009. MMWR Morb Mortal Wkly Rep 2009;58, 536–554
Ozdemir H, Kendirli T, Dinçaslan HU, et al. Spontaneous pneumomediastinum in a child due to 2009 pandemic influenza A (H1N1) virus. Turk J Pediatr 2010;52:648–651
Udupa S, Hameed T, Kovesi T. Pneumomediastinum and subcutaneous emphysema associated with pandemic (H1N1) influenza in three children. CMAJ 2011;183:220–222
Caceres M, Ali SZ, Braud R, et al., Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg 2008;86, 962–963
Chalumeau M, Le Clainche L, Sayeg N, et al., Spontaneous pneumomediastinum in children. Pediatr Pulmonol 2001;31:67–75
Romero J, Izquierdo Hidalgo J, Macià Botejara E, et al., Spontaneous pneumopericardium in a patient with community-aquired pneumonia. Rev Esp Cardiol 2005, 58, 227–229
Oertel MF, Korinth MC, Reinges MH, et al. Pathogenesis, diagnosis and management of pneumorrhachis. Eur Spine J 2006;15, 636–643
Aribas OK, Gormus N, Aydogdu Kiresi D. Epidural emphysema associated with primary spontaneous pneumothorax. Eur J Cardiothorac Surg 2001;20, 645–646
Chiba Y, Kakuta H. Massive subcutaneous emphysema, pneumomediastinum, and spinal epidural emphysema as complications of violent coughing: a case report. Auris Nasus Larynx 1995;22, 205–208
Tutor JD, Montgomery VL, Eid NS. A case of influenza virus bronchiolitis complicated by pneumomediastinum and subcutaneous emphysema. Pediatr Pulmonol 1995;19, 393–395.
Shimizu T, Mochizuki H, Morikawa A. Effect of influenza A virus infection on acid-induced cough response in children with asthma. Eur Respir J 1997;10, 71–74
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Pierri, F., Chiaretti, A., Barone, G. et al. Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children. cent.eur.j.med 6, 386–389 (2011). https://doi.org/10.2478/s11536-011-0036-y
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DOI: https://doi.org/10.2478/s11536-011-0036-y