{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:06:41Z","timestamp":1766725601509,"version":"3.48.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,1]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Spontaneous pneumomediastinum (SPM) is a rare condition in which air accumulates within the mediastinum without preceding trauma or medical procedures. It typically affects young adults and may present with acute chest pain, dyspnoea or subcutaneous emphysema. The Macklin effect\u2014alveolar rupture with air tracking along bronchovascular sheaths\u2014explains its pathophysiology, and Hamman\u2019s sign may be detected on auscultation.<\/jats:p>\n                  <jats:p>We present a female in her mid-20s who developed shortness of breath and neck swelling after a 5 day sore throat without cough. Examination revealed subcutaneous crepitus, and CT confirmed pneumomediastinum with extensive subcutaneous emphysema. She was managed conservatively with high-flow oxygen, analgesia and antibiotics, improving markedly within 24 hours. No surgical intervention was required, and follow-up imaging showed complete resolution.<\/jats:p>\n                  <jats:p>SPM should be suspected in patients with respiratory symptoms and subcutaneous emphysema, even without trauma or typical risk factors. Prompt diagnosis and supportive management usually result in excellent outcomes.<\/jats:p>","DOI":"10.1136\/bcr-2025-269185","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:05:20Z","timestamp":1766725520000},"page":"e269185","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous pneumomediastinum with extensive subcutaneous emphysema secondary to upper respiratory tract infection"],"prefix":"10.1136","volume":"18","author":[{"given":"Azmat Ullah","family":"Jan","sequence":"first","affiliation":[{"name":"Rehman Medical Institute, Peshawar, N.W.F.P, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2069-9533","authenticated-orcid":false,"given":"Waqas","family":"Fazal","sequence":"additional","affiliation":[{"name":"Neurology, Royal Stoke University Hospital, Stoke-on-Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hammad","family":"Saif","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, N.W.F.P, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haq Nawaz","family":"Khan","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, N.W.F.P, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima","family":"Aman","sequence":"additional","affiliation":[{"name":"Rehman Medical College, Peshawar, N.W.F.P, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imdad","family":"Ullah","sequence":"additional","affiliation":[{"name":"Khyber Medical College, Peshawar, N.W.F.P, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"2025122521050936000_18.12.e269185.1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.5.3298"},{"key":"2025122521050936000_18.12.e269185.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.04.067"},{"key":"2025122521050936000_18.12.e269185.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1943.00210020122008"},{"key":"2025122521050936000_18.12.e269185.4","unstructured":"Laennec RT , Forbes J . A treatise on the diseases of the chest and on mediate auscultation. Philadelphia: John Grigg, 1830."},{"key":"2025122521050936000_18.12.e269185.5","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1939.00190050019003"},{"key":"2025122521050936000_18.12.e269185.6","doi-asserted-by":"publisher","DOI":"10.1177\/1753465809350888"},{"key":"2025122521050936000_18.12.e269185.7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.5582\/irdr.2024.01020","article-title":"Spontaneous pneumomediastinum: A comprehensive review of diagnosis and management","volume":"13","author":"Talwar","year":"2024","journal-title":"Intractable Rare Dis Res"},{"key":"2025122521050936000_18.12.e269185.8","doi-asserted-by":"crossref","first-page":"4","DOI":"10.21037\/med-23-25","article-title":"A clinical review of spontaneous pneumomediastinum","volume":"8","author":"Susai","year":"2024","journal-title":"Mediastinum"},{"key":"2025122521050936000_18.12.e269185.9","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v6.i11.850"},{"key":"2025122521050936000_18.12.e269185.10","doi-asserted-by":"crossref","first-page":"e1051","DOI":"10.1097\/PEC.0000000000001895","article-title":"Management and Outcomes of Spontaneous Pneumomediastinum in Children","volume":"37","author":"Noorbakhsh","year":"2021","journal-title":"Pediatr Emerg Care"},{"key":"2025122521050936000_18.12.e269185.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.03.008"},{"key":"2025122521050936000_18.12.e269185.12","first-page":"10","article-title":"Presentation and management of pneumomediastinum in patients with COVID-19 infection","volume":"11","author":"Karim","year":"2023","journal-title":"Southwest Respir Crit Care Chron"},{"key":"2025122521050936000_18.12.e269185.13","article-title":"Spontaneous Pneumomediastinum in a 16-Year-Old Patient with SARS-CoV-2 Infection: A North-East Romanian Case","volume":"9","author":"Filip","year":"2022","journal-title":"Children (Basel)"},{"key":"2025122521050936000_18.12.e269185.14","doi-asserted-by":"crossref","first-page":"102854","DOI":"10.1016\/j.epsc.2024.102854","article-title":"Spontaneous pneumomediastinum in previously healthy pediatric patients: A case series","volume":"108","author":"Brito Rojas","year":"2024","journal-title":"J Pediatr Surg Case Rep"},{"key":"2025122521050936000_18.12.e269185.15","doi-asserted-by":"crossref","first-page":"37","DOI":"10.11604\/pamj.2021.38.37.27543","article-title":"Spontaneous pneumomediastinum and subcutaneous emphysema in a non-intubated COVID-19 patient: a case report","volume":"38","author":"Jatoi","year":"2021","journal-title":"Pan Afr Med J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T05:05:21Z","timestamp":1766725521000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":15,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,25]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-269185"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269185","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}