Simple cough as a cause of subcutaneous emphysema

Description

This X-ray is of a healthy 3-year-old girl who presented with fever and cough for 2 days. She had been admitted in a private clinic and started on oral antibiotics for upper respiratory tract infection. On the second day of her symptoms her parents noticed swelling of the neck and upper chest and the child was brought to the emergency department.

On examination the girl was stable and not in respiratory distress. Subcutaneous emphysema was noticed clinically (by crepitus) and chest auscultation was normal.

Figure 1 is the chest X-ray on the day of admission showing vast subcutaneous and mediastinal emphysema.

Figure 1.

Showing vast subcutaneous and mediastinal emphysema on the day of admission.

The child was admitted for observation and stayed in the hospital for 2 days. She was discharged in good condition as her subcutaneous emphysema improved clinically and her chest X-ray after 2 days showed significant resolution of the emphysema (figure 2).

Figure 2.

Showing significant resolution of emphysema after 2 days.

Learning points.

• Subcutaneous emphysema could be a complication of a simple cough.

• When there is no serious cause of emphysema, the symptoms are minimal even with a vast one and the resolution is fast.