Spontaneous Pneumomediastinum and Subcutaneous Emphysema: Unusual Presentation of H1N1 Influenza in Adult

Swine flu is highly contagious acute respiratory disease caused by a subtype of influenza A virus. After the 2009 H1N1 virus pandemia the strain has caused multiple localized outbreaks in various part of the world. It typically presents with fever, cough, sore throat, fatigue, headache, dyspnea, myalgia, vomiting, and diarrhea but rarely severe complications like rapidly progressive pneumonia, septic shock and multi-organ failure may appear.

H1N1 swine influenza complicating with spontaneous pneumomediastinum is uncommon, occurring mostly in children with a predisposing co-morbidity like asthma. Though rare, its occurrence in adult should be considered a possibility. Pneumomediastinum is potentially life threatening if not diagnosed and managed promptly.

Here we report in detail a case of adult H1N1 swine influenza developing spontaneous pneumomediastinum (SPM) in absence of any known predisposing comorbidity.