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Spontaneous pneumopericardium, pneumomediastinum and subcutaneous emphysema: unusual complications of asthma in a 2-year-old boy
  1. V Ameh1,
  2. R Jenner1,
  3. N Jilani2,
  4. A Bradbury2
  1. 1Emergency Department, South Manchester University Hospital, Manchester, UK
  2. 2Department of Paediatrics, South Manchester University Hospital, Manchester, UK
  1. Correspondence to:
 Dr Victor Ameh
 36 Kenworthy Lane, Northenden, Manchester M22 4EJ, UK; amehyaks{at}


A 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.

  • ECG, electrocardiogram

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  • Competing interests: The manuscript was prepared by the authors. There was no external funding, outside support or any financial interest in the preparation of this work. No other competing interest is declared.