Emphysema of Multi-compartment in Asthmatic Patient: Subcutaneous, Mediastinal, Pericardial, and Spinal Pneumatosis

Varying degrees of emphysema can be seen in the acute phase of asthma due to increased intra-bronchial and intra-alveolar pressure induced by severe cough. Emphysemas can be simple subcutaneous to spinal pneumatosis. Case Report: A male patient, aged 22, was admitted to the emergency service with complaints of dyspnea. He was in an acute asthmatic attack and had diffuse subcutaneous emphysema. Pneumatosis was localized in the base of skull, spinal canal, mediastinum, and pericardium. During his hospital stay, he was intubated, and tube thoracotomy was performed bilaterally at the intensive care unit. His bronchoscopy revealed no pathological findings. Anti-asthmatic treatment and antibiotic therapy were also administered, and the patient was discharged from the hospital on day 14 after admission. Conclusion: The literature contains rare reports of acute asthmatic attacks and emphysemas, pneumomediastinum, and spinal pneumatosis, which are mostly isolated findings. The case reported in this paper should remind physicians that pneumatosis could be widespread among many different compartments at the same time, which can complicate the situation and require decompression together with anti-asthmatic treatment.