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Published on: November 4, 2010
Simultaneous spontaneous bilateral pneumothoraces in an asthmatic.
J Williams-Johnson1, E W Williams, N Hart
1Emergency Medicine Division, The University of the West Indies, Kingston 7, Jamaica. jeanjohnson@cwjamaica.com
The West Indian Medical Journal
|July 2, 2009
Summary
Simultaneous spontaneous bilateral pneumothoraces, a rare event, occurred in a 14-year-old asthmatic patient during routine nebulization. Prompt treatment with needle thoracocentesis and chest tubes led to a full recovery.
Area of Science:
- Medicine
- Pulmonology
- Emergency Medicine
Background:
- Spontaneous pneumothorax is the presence of air in the pleural space not caused by trauma.
- Simultaneous spontaneous bilateral pneumothoraces are exceedingly rare, particularly in non-ventilated patients.
Observation:
- A 14-year-old female with a history of asthma presented for routine nebulization treatment.
- During treatment, she developed sudden supraclavicular fullness and crepitus, indicative of subcutaneous emphysema.
- Clinical examination confirmed the diagnosis of bilateral pneumothoraces.
Findings:
- The patient experienced simultaneous spontaneous bilateral pneumothoraces while undergoing nebulization therapy.
- This rare presentation highlights a potential complication outside of typical associations like mechanical ventilation.
- The patient underwent successful and rapid treatment with bilateral needle thoracocentesis and thoracostomy tubes.
Implications:
- Physicians should maintain a high index of suspicion for bilateral pneumothoraces even in non-ventilated patients presenting with respiratory distress.
- Early recognition and aggressive intervention are crucial for managing this rare but life-threatening condition.
- This case underscores the importance of considering unusual presentations of common conditions in pediatric patients with asthma.
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