Epidural pneumorrhachis, a rare complication of asthma exacerbation

J Asthma. 2019 Dec;56(12):1356-1359. doi: 10.1080/02770903.2018.1539101. Epub 2019 Jan 10.

Abstract

Introduction: An association between pneumorrhachis and asthma exacerbation is uncommon. However, we present a clinical case involving a patient with exacerbated asthma, subcutaneous emphysema, spontaneous pneumomediastinum (SPM), and pneumorrhachis. Case study: The patient was an 18-year-old male with asthma since childhood who only relied on salbutamol to control his asthma symptoms. Results: The patient suddenly experienced dyspnea, chest tightness, and paroxysmal coughing, which prompted him to visit the emergency department. Upon arrival, subcutaneous emphysema was detected on the face, neck, thorax, and left forearm. Chest X-ray showed air in the mediastinum, neck, left supraclavicular region, and chest, all of which were verified by a computed tomography scan that also revealed air in the epidural region. At the hospital, his treatment focused on preventing asthma exacerbation and managing associated symptoms. Conclusion: When a patient has asthma exacerbation that is accompanied by SPM and extensive emphysema, the presence of epidural pneumorrhachis should not be overlooked.

Keywords: Case reports; diagnostics; pediatrics.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Anti-Bacterial Agents / administration & dosage
  • Asthma / complications*
  • Asthma / diagnosis
  • Asthma / drug therapy
  • Bronchodilator Agents / administration & dosage
  • Cough / diagnosis
  • Cough / etiology
  • Disease Progression
  • Drug Therapy, Combination
  • Dyspnea / diagnosis
  • Dyspnea / etiology
  • Emergency Service, Hospital
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Mediastinal Emphysema / diagnostic imaging*
  • Mediastinal Emphysema / drug therapy
  • Mediastinal Emphysema / etiology
  • Pneumorrhachis / diagnostic imaging*
  • Pneumorrhachis / drug therapy
  • Pneumorrhachis / etiology
  • Rare Diseases
  • Risk Assessment
  • Spinal Canal / diagnostic imaging*
  • Spinal Canal / pathology
  • Subcutaneous Emphysema / diagnostic imaging*
  • Subcutaneous Emphysema / drug therapy
  • Subcutaneous Emphysema / etiology
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Bronchodilator Agents