Spontaneous pneumomediastinum complicating pneumonia in children infected with the 2009 pandemic influenza A (HINI) virus

Hasegawa, Maki; Hashimoto, Koji; Morozumi, Miyuki; Ubukata, Kimiko; Takahashi, Takashi; Inamo, Yasuji

doi:10.1111/j.1469-0691.2009.03086.x

Cited by 38 publications

(36 citation statements)

References 14 publications

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“…Spontaneous pneumomediastinum following influenza H1N1 virus infection is extremely rare and in literature there are a few reports on this association [2,[5][6]. To the best of our knowledge, at the moment, this is the first case of pneumorrachis associated with H1N1 infection, while no association with other influenza virus infection is reported in literature.…”

Section: Discussionmentioning

confidence: 74%

“…The novel influenza A H1N1 virus was identified as the main cause of the sudden outbreak of several febrile respiratory infections ranging from selflimited to severe illness both in children and adults. Children may be more liable to catch an H1N1 infection presenting with fever, violent cough, dyspnea, and bilateral patchy pulmonary shadows upon the inspection of the chest radiograph [2]. Moreover, when patients are younger than 2 years of age they are at higher risk of being hospitalized [3].…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children

et al. 2011

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AbstractWe 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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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children

et al. 2011

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“…2 Although there is a wellestablished link between underlying respiratory illnesses, especially asthma, and spontaneous pneumomediastinum, 3,4 our experience with the three patients we have described supports the association of pandemic (H1N1) influenza with air leak syndrome, including pneumomediastinum, and subcutaneous and prevertebral emphysema in a different pediatric population.…”

Section: Key Pointsmentioning

confidence: 84%

“…2 The patients were six and eight years of age, and neither had a history of asthma. Soto-Abraham and coworkers reported that pathologic features of fatal pandemic (H1N1) influenza included hemorrhage and necrosis of the upper respiratory tract and necrosis of the bronchiolar walls.…”

mentioning

confidence: 99%

Pneumomediastinum and subcutaneous emphysema associated with pandemic (H1N1) influenza in three children

Udupa¹,

Hameed²,

Kovesi³

2010

Canadian Medical Association Journal

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A nine-year-old girl presented to the emergency department in the fall of 2009 with a one-week history of cough, neck swelling, sore throat and mild diarrhea, but no fever or vomiting. She had a history of asthma, which was treated with montelukast. Her physical examination showed subcutaneous emphysema above the clavicles. A chest radiograph showed pneumomediastinum (Figure 1). She was discharged home but returned several hours later with worsening symptoms. A neck radiograph showed massive subcutaneous emphysema in the prevertebral space (Figure 2). An echocardiogram showed a very small localized pneumopericardium over the left ventricle. Polymerase chain reaction testing of nasal secretions was positive for pandemic (H1N1) 2009 virus. She was admitted to the pediatric intensive care unit and given 100% oxygen therapy, inhaled salbutamol and oral oseltamivir. She was also given antibiotics empirically, because of the potential loss of sterility of the prevertebral space. Apart from lingering fever, she recovered uneventfully and was discharged after five days.A 14-year-old boy presented to the emergency department in the fall of 2009 with a fiveday history of fever, cough, sore throat, abdominal pain and fatigue. There was no history of vomiting. He had a history of very mild asthma, having last used inhaled salbutamol over a year earlier. He had mild tachypnea. There was limitation in lateral neck movement, but no subcutaneous emphysema on palpation. Neck and chest radiographs showed subcutaneous air at the sternoclavicular notch and anterior to the cervical vertebra, but no pneumomediastinum or pneumopericardium. Testing of nasal secretions by polymerase chain reaction was positive for pandemic (H1N1) 2009 virus. He was given oral oseltamivir; he rapidly improved and was discharged within three days.A three-year-old boy presented to the emergency department in the fall of 2009 with a fourday history of fever, cough, runny nose and sudden-onset neck swelling. He had vomited once. He had been diagnosed with asthma six months earlier, but had been using inhaled corticosteroids and bronchodilators inconsistently for the past five months. He was tachycardic, with a maximum heart rate of 160 beats/min, and tachypneic, with a maximum respiratory rate of 62 breaths/min. He required supplemental oxygen to maintain oxygen saturation above 92%. There was palpable subcutaneous emphysema at the face, neck, chest and upper abdomen. He had increased respiratory effort and a prolonged expiratory phase. His chest radiograph showed subcutaneous emphysema and pneumomediastinum. Testing of his nasal secretions by polymerase chain reaction was positive for pandemic (H1N1) 2009 virus. He was given oral oseltamivir, 100% oxygen therapy, antibiotics, inhaled salbutamol and oral corticosteroids. He had an uncomplicated course and was discharged after four days. DiscussionInfection with pandemic (H1N1) 2009 virus has been associated with severe respiratory complications in children, including secondary bacterial pneumonia and respira...

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“…Up till now there have been no reported cases of pneumomediastinum complicating pneumonia in adolescents by a novel swine origin influenza A (H1N1). Only Hasegawa et al 6 has reported 2 patients who have had asthma or asthmatic symptoms. Our patient, though, showed unusual clinical signs such as blood tinged sputum and no wheezing, radiologic signs that are typical of pneumomediastinum with pneumonia.…”

Section: Discussionmentioning

confidence: 99%

A Case of Novel Influenza A (H1N1) Virus Pneumonia Complicated Pnemomediastinum and Subcutenous Emphysema

et al. 2011

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Spontaneous pneumomediastinum complicating pneumonia in children infected with the 2009 pandemic influenza A (HINI) virus

Cited by 38 publications

References 14 publications

Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children

Spontaneous Pneumomediastinum, Pneumopericardium and Pneumorrhachis as potential complications of 2009 pandemic influenza A (H1N1) virus infection in healthy children

Pneumomediastinum and subcutaneous emphysema associated with pandemic (H1N1) influenza in three children

A Case of Novel Influenza A (H1N1) Virus Pneumonia Complicated Pnemomediastinum and Subcutenous Emphysema

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