Hypoxemia in an adolescent: when the cause is between the lines
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.25753/BirthGrowthMJ.v29.i4.14106 |
Resumo: | Spontaneous pneumomediastinum is a rare entity in pediatric age, with multifactorial etiology. A 16-year-old male with multiple allergies (mites, dogs, cats, and grasses), daily smoker (one pack/day for one year), and regular cannabis, cocaine, and amphetamine consumer went to the Emergency Department of the local hospital with cough, dyspnea, chest pain, and fever with 12 hours of evolution. On physical examination, the boy presented facies complaints, polypnea, shortness of breath, extensive subcutaneous emphysema in the cervical region and right hemithorax, and diminished vesicular murmur bilaterally with expiratory wheezing. Chest x-ray was performed, revealing alterations compatible with pneumomediastinum and subcutaneous emphysema in the cervical region. Urine test was positive for tetrahydrocannabinoids. Atopy (IgE levels) study was performed, with positive result, and serological testing was performed for Mycoplasma pneumoniae, showing IgM of 33U/mL and IgG of 25U/mL. In this clinical case, multiple pneumomediastinum triggering/predisposing factors can be identified, including marked smoking habits, acute mycoplasma infection, and inhaled and smoked drug consumption. The aim of this study was to review the pathophysiology/semiology of pneumomediastinum and emphasize the importance of clinical suspicion. |
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Hypoxemia in an adolescent: when the cause is between the linesHipoxemia num adolescente: quando a causa está nas entrelinhasCase ReportsSpontaneous pneumomediastinum is a rare entity in pediatric age, with multifactorial etiology. A 16-year-old male with multiple allergies (mites, dogs, cats, and grasses), daily smoker (one pack/day for one year), and regular cannabis, cocaine, and amphetamine consumer went to the Emergency Department of the local hospital with cough, dyspnea, chest pain, and fever with 12 hours of evolution. On physical examination, the boy presented facies complaints, polypnea, shortness of breath, extensive subcutaneous emphysema in the cervical region and right hemithorax, and diminished vesicular murmur bilaterally with expiratory wheezing. Chest x-ray was performed, revealing alterations compatible with pneumomediastinum and subcutaneous emphysema in the cervical region. Urine test was positive for tetrahydrocannabinoids. Atopy (IgE levels) study was performed, with positive result, and serological testing was performed for Mycoplasma pneumoniae, showing IgM of 33U/mL and IgG of 25U/mL. In this clinical case, multiple pneumomediastinum triggering/predisposing factors can be identified, including marked smoking habits, acute mycoplasma infection, and inhaled and smoked drug consumption. The aim of this study was to review the pathophysiology/semiology of pneumomediastinum and emphasize the importance of clinical suspicion.O pneumomediastino espontâneo é uma entidade rara em idade pediátrica e de etiologia multifatorial. Um adolescente de 16 anos de idade, com história de múltiplas alergias (ácaros, cães, gatos e gramíneas), hábitos tabágicos marcados (um maço/dia há um ano) e consumo de canábis, cocaína e anfetaminas recorreu ao Serviço de Urgência por tosse seca irritativa, dispneia, dor torácica e febre com 12 horas de evolução. Ao exame objetivo, encontrava-se queixoso da fácies, polipneico, com tiragem global e extenso enfisema subcutâneo na região cervical e hemitórax direito e murmúrio vesicular diminuído com sibilos expiratórios bilateralmente. A radiografia torácica revelou alterações compatíveis com pneumomediastino e enfisema subcutâneo na região cervical. A pesquisa de abuso de drogas na urina foi positiva para tetrahidrocanabinóides. O estudo de atopia (imunoglobulina E total e imunoglobulinas especificas) foi positivo e a serologia para Mycoplasma pneumoniae revelou IgM de 33U/mL e IgG de25U/mL. Múltiplos fatores desencadeantes/predisponentes de pneumomediastino podem ser identificados neste caso clínico, nomeadamente hábitos tabágicos marcados, infeção aguda por micoplasma e consumo de drogas inaladas e fumadas. O objetivo deste estudo é alertar para a fisiopatologia/semiologia do pneumomediastino e salientar a importância da suspeita clínica.Centro Hospitalar Universitário do Porto2020-11-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.25753/BirthGrowthMJ.v29.i4.14106eng2183-9417Pereira, TatianaLoureiro, GraçaPereira, SandraRocha, CristinaGuimarães, PauloOliveira, Sarainfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-09-21T14:55:29Zoai:ojs.revistas.rcaap.pt:article/14106Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:56:26.506488Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hypoxemia in an adolescent: when the cause is between the lines Hipoxemia num adolescente: quando a causa está nas entrelinhas |
title |
Hypoxemia in an adolescent: when the cause is between the lines |
spellingShingle |
Hypoxemia in an adolescent: when the cause is between the lines Pereira, Tatiana Case Reports |
title_short |
Hypoxemia in an adolescent: when the cause is between the lines |
title_full |
Hypoxemia in an adolescent: when the cause is between the lines |
title_fullStr |
Hypoxemia in an adolescent: when the cause is between the lines |
title_full_unstemmed |
Hypoxemia in an adolescent: when the cause is between the lines |
title_sort |
Hypoxemia in an adolescent: when the cause is between the lines |
author |
Pereira, Tatiana |
author_facet |
Pereira, Tatiana Loureiro, Graça Pereira, Sandra Rocha, Cristina Guimarães, Paulo Oliveira, Sara |
author_role |
author |
author2 |
Loureiro, Graça Pereira, Sandra Rocha, Cristina Guimarães, Paulo Oliveira, Sara |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Pereira, Tatiana Loureiro, Graça Pereira, Sandra Rocha, Cristina Guimarães, Paulo Oliveira, Sara |
dc.subject.por.fl_str_mv |
Case Reports |
topic |
Case Reports |
description |
Spontaneous pneumomediastinum is a rare entity in pediatric age, with multifactorial etiology. A 16-year-old male with multiple allergies (mites, dogs, cats, and grasses), daily smoker (one pack/day for one year), and regular cannabis, cocaine, and amphetamine consumer went to the Emergency Department of the local hospital with cough, dyspnea, chest pain, and fever with 12 hours of evolution. On physical examination, the boy presented facies complaints, polypnea, shortness of breath, extensive subcutaneous emphysema in the cervical region and right hemithorax, and diminished vesicular murmur bilaterally with expiratory wheezing. Chest x-ray was performed, revealing alterations compatible with pneumomediastinum and subcutaneous emphysema in the cervical region. Urine test was positive for tetrahydrocannabinoids. Atopy (IgE levels) study was performed, with positive result, and serological testing was performed for Mycoplasma pneumoniae, showing IgM of 33U/mL and IgG of 25U/mL. In this clinical case, multiple pneumomediastinum triggering/predisposing factors can be identified, including marked smoking habits, acute mycoplasma infection, and inhaled and smoked drug consumption. The aim of this study was to review the pathophysiology/semiology of pneumomediastinum and emphasize the importance of clinical suspicion. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-11-27T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.25753/BirthGrowthMJ.v29.i4.14106 |
url |
https://doi.org/10.25753/BirthGrowthMJ.v29.i4.14106 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
2183-9417 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Centro Hospitalar Universitário do Porto |
publisher.none.fl_str_mv |
Centro Hospitalar Universitário do Porto |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799130432625704960 |