Spontaneous pneumomediastinum: A rare complication of methamphetamine use

Albanese, Jessica; Gross, Cole D.; Azab, Mohamed; Mahalean, Sinziana; Makar, Ranjit

doi:10.1016/j.rmcr.2017.03.007

Cited by 9 publications

(12 citation statements)

References 9 publications

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“…That being said, the patient also had a significant inhalational drug history, including daily marijuana and frequent methamphetamine use (UDS was positive for cannabinoids, negative for amphetamines). Stimulants have been shown to be both a precipitating and predisposing factor in pneumomediastinum, including methamphetamine as seen in this patient [1] . Cocaine, crack cocaine, and ice methamphetamine involve aggressive inhalation, as well as performance of Valsalva maneuvers, prior to exhalation.…”

Section: Discussionmentioning

confidence: 61%

A peculiar case of asymptomatic spontaneous pneumomediastinum

Irwin

Rishi

Upadhyay

2017

Respiratory Medicine Case Reports

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ObjectiveTo present a case of asymptomatic spontaneous pneumomediastinum and review available evidence-based workup and management.Case presentationA young Caucasian adult male with a history of inhalational drug use was admitted to the internal medicine service for evaluation of dehydration and mild rhabdomyolysis. Patient had been on the run from the police and had spent the last days prior to presentation without food, water, or shelter. On admission, patient had no complaints, except for thirst. It was detected on physical exam and chest x-ray that patient had subcutaneous emphysema and pneumomediastinum. The patient was treated conservatively and discharged after a period of observation.ConclusionSpontaneous pneumomediastinum is benign and seen primarily in young adults. It is more commonly associated with symptoms like chest pain and/or dyspnea, making an asymptomatic case particularly distinctive. The etiologies and precipitating factors are varied and often an apparent cause isn't identified. The diagnostic approach involves chest x-ray and/or computed tomography (CT) chest with further workup being largely unnecessary. The tenants of management include bedrest, analgesics, and supplemental oxygen as needed.

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Section: Discussionmentioning

confidence: 61%

A peculiar case of asymptomatic spontaneous pneumomediastinum

Irwin

Rishi

Upadhyay

2017

Respiratory Medicine Case Reports

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“…Once these diagnoses are excluded SPM may be diagnosed. Drugs, including cocaine, met(amphetamine), MDMA, marihuana and, as presented, mephedrone may cause SPM and consequently pneumomediastinum and subcutaneous emphysema [5,6,7,8]. Probable explanation of development SPM as a result of inhalable drug use is that overly distended alveoli rupture under high pressure.…”

Section: Discussionmentioning

confidence: 88%

Pneumomediastinum and pneumoretroperitoneum as a result of mephedrone intoxication – a case report.

Perdyan

Piatkowska

Spychalski

et al. 2018

Disaster Emerg Med J

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IntroductIon: Presence of air in mediastinal space, retroperitoneal space or subcutaneously is a rare condition in majority caused by trauma of airway or gastrointestinal (GI) tract. Rarely can it occur as a consequence after drug usage. cAse presentAtIon: We report a non-traumatic occurrence of pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema in a 27 year-old male patient who had been inhaling mephedrone for 4 days. Patient was admitted to Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk. CT scans of neck, chest and abdomen were performed with suspicion of perforation of GI tract or airways. Perforation was excluded by gastroscopic and bronchoscopic examinations. Patient was treated conservatively with fluids and antibiotic therapy because of no abnormalities besides free air in mentioned cavities. During 6 days of hospitalization patient made a steady recovery and was discharged in good condition. conclusIons: The presence of pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema associated with mephedrone inhalation has been rarely reported in the literature in the past. There are only a few cases describing such complications and medical management required. By reporting this case we would like to emphasize that mentioned symptoms and history of drug use might seem life-threatening, however, this condition may be self-limiting as well. Therefore, good general state can potentially be indication for a watch-and-wait approach with no surgical intervention necessary.

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“…Another proposed possibility of alveolar rupture in illicit drug users was the presence of contaminants in the drug preparations causing Case Reports in Pulmonology alveolar injury [2]. There are limited case reports on pneumomediastinum with concomitant use of methamphetamine, ecstasy, and mephedrone [3][4][5]7]. In this particular case, pneumomediastinum occurred due to inhalational injury from methamphetamine.…”

Section: Discussionmentioning

confidence: 90%

“…Emesis and asthma flare-ups may trigger free air in the mediastinum; however, in many cases, there is no triggering event identified [2]. Illicit stimulants such as cocaine, methamphetamine, ecstasy, and mephedrone have been associated with pneumomediastinum [3][4][5][6][7]. Subcutaneous emphysema may occur when air from the ruptured bronchoalveolar wall escapes into the subcutaneous plane.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Pneumomediastinum and Diffuse Subcutaneous Emphysema after Methamphetamine Inhalation

Agustin

David

Kang

et al. 2020

Case Reports in Pulmonology

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Methamphetamines are commonly abused drugs for their stimulant and euphoric effects. Inhaled and intravenous use may cause damage to the respiratory system. Spontaneous pneumomediastinum is a condition where changes in intrathoracic pressure leads to alveolar rupture and dissection of air along the tracheobronchial tree. Massive subcutaneous emphysema may result from pneumomediastinum which may compromise the central airway. In this case report, we present an unusual case of spontaneous pneumomediastinum and severe subcutaneous emphysema following inhalation of methamphetamine. This case emphasizes the rising concern on the acute respiratory complications of methamphetamine use.

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Spontaneous pneumomediastinum: A rare complication of methamphetamine use

Cited by 9 publications

References 9 publications

A peculiar case of asymptomatic spontaneous pneumomediastinum

A peculiar case of asymptomatic spontaneous pneumomediastinum

Pneumomediastinum and pneumoretroperitoneum as a result of mephedrone intoxication – a case report.

Spontaneous Pneumomediastinum and Diffuse Subcutaneous Emphysema after Methamphetamine Inhalation

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