Subcutaneus Emphysema– a Very Rare Asthma Complication
Raihan Ar’ Rachman¹, Prayudi Santoso², Yana Akhmad Suryana²
¹Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran,
Bandung, Indonesia
²Division of Pulmonology and Critical Care, Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty
of Medicine, Universitas Padjadjaran, Bandung, Indonesia
ABSTRACT
Background:
Asthma is a chronic inflammatory disease that causes partially or completely reversible airway obstruction¹. Common asthma complications include severe asthma and severe hypoxemia. Pneumomediastinum and subcutaneous emphysema represent rare complications of acute asthma exacerbation. The incidence of pneumomediastinum is approximately 1:44,000, with 70% presenting with subcutaneous emphysema. The underlying mechanism is characterized by alveolar rupture due to a sudden increase in intrathoracic pressure Although typically self-limiting, delayed recognition may lead to potentially serious outcomes⁴.
Case Presentation:
We report a female who presented with shortness of breath for two days prior to admission, accompanied by productive cough with yellow sputum and fever. The patient further experienced (don’t repeat “accompanied by”) swelling of the neck extending to the chest, along with pain and wheezing during breathing. The patient had a history of asthma with almost daily exacerbations and chronic electronic cigarette use. Examination showed neck-to-chest swelling with crepitus and bilateral wheezing. Radiography confirmed that she had pneumonia, pneumomediastinum, and subcutaneous emphysema. She was treated with antibiotics, bronchodilators, and supportive therapy, and improved within five days.
Conclusion:
Subcutaneous emphysema is a rare complication of acute asthma exacerbation. Although generally self-limiting, rapid diagnosis through clinical and radiological evaluation can prevent more severe complications. Conservative treatment provides good outcomes when performed promptly and appropriately.
Keywords: asthma, pneumomediastinum, subcutaneous emphysema
