{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T04:26:37Z","timestamp":1762057597818,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T00:00:00Z","timestamp":1657670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Spontaneous pneumomediastinum (SP) is generally a benign condition which can have various etiologies. Data on SP related to respiratory viral infections in children are rare and there are currently no official guidelines or consistent treatment recommendations for these patients. Aim: To discuss treatment options considering the recommendations for SP with different etiologies. Methods: We report three cases of SP, which were related to rhinovirus or respiratory syncytial virus (RSV) infection. Results: All three patients presented with typical symptoms of a respiratory tract infection and required oxygen supplementation during the hospital stay. All children benefited from a conservative, supportive therapy, and bed rest, and could be discharged after seven days or less without remaining symptoms. Conclusion: Surveillance and monitoring might be reasonable to detect and treat potential complications in children with SP due to viral infections, as one child developed an increasing pneumothorax, which had to be treated with a thoracic drainage.<\/jats:p>","DOI":"10.3390\/children9071040","type":"journal-article","created":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T22:06:00Z","timestamp":1657749960000},"page":"1040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Spontaneous Pneumomediastinum in Children with Viral Infections: Report of Three Cases Related to Rhinovirus or Respiratory Syncytial Virus Infection"],"prefix":"10.3390","volume":"9","author":[{"given":"Johanna L.","family":"Leinert","sequence":"first","affiliation":[{"name":"University Children\u2019s Hospital, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany"},{"name":"Department of Neonatology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2246-7982","authenticated-orcid":false,"given":"Alba","family":"Perez Ortiz","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2035-8598","authenticated-orcid":false,"given":"Neysan","family":"Rafat","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/01.pec.0000248686.88809.fd","article-title":"Spontaneous pneumomediastinum in children: A literature review","volume":"23","author":"Bullaro","year":"2007","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"460","DOI":"10.4103\/1947-2714.117296","article-title":"Spontaneous pneumomediastinum: Time for consensus","volume":"5","author":"Sahni","year":"2013","journal-title":"N. Am. J. Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/1099-0496(200101)31:1<67::AID-PPUL1009>3.0.CO;2-J","article-title":"Spontaneous pneumomediastinum in children","volume":"31","author":"Chalumeau","year":"2001","journal-title":"Pediatr. Pulmonol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.jpedsurg.2015.03.024","article-title":"Management of spontaneous pneumomediastinum in children","volume":"50","author":"Fitzwater","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_5","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":"2019","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e933405","DOI":"10.12659\/AJCR.933405","article-title":"Spontaneous Pneumomediastinum and Pneumothorax in Nonintubated COVID-19 Patients: A Multicenter Case Series","volume":"22","author":"Iuorio","year":"2021","journal-title":"Am. J. Case Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"00346-2021","DOI":"10.1183\/23120541.00346-2021","article-title":"Radiological-pathological signatures of patients with COVID-19-related pneumomediastinum: Is there a role for the Sonic hedgehog and Wnt5a pathways?","volume":"7","author":"Baratella","year":"2021","journal-title":"ERJ Open Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e05543","DOI":"10.1002\/ccr3.5543","article-title":"Young convalescent COVID-19 pneumonia with extensive pneumomediastinum emphysema: Case report","volume":"10","author":"Jagosz","year":"2022","journal-title":"Clin. Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1111\/ped.12785","article-title":"Pneumomediastinum, pneumorrhachis and subcutaneous emphysema associated with viral infections: Report of three cases","volume":"57","author":"Emiralioglu","year":"2015","journal-title":"Pediatr. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1055\/s-0032-1329948","article-title":"Pneumomediastinum and subcutaneus emphysema\u2014An uncommon presentation of respiratory-syncytial virus infection in an infant","volume":"225","author":"Dehmel","year":"2013","journal-title":"Klin Padiatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jcv.2006.12.005","article-title":"Epidemiological and clinical features of hMPV, RSV and RVs infections in young children","volume":"38","author":"Manoha","year":"2007","journal-title":"J. Clin. Virol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1007\/s00586-006-0160-6","article-title":"Pathogenesis, diagnosis and management of pneumorrhachis","volume":"15","author":"Oertel","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.athoracsur.2008.04.067","article-title":"Spontaneous pneumomediastinum: A comparative study and review of the literature","volume":"86","author":"Caceres","year":"2008","journal-title":"Ann. Thorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1016\/j.amjsurg.2015.08.002","article-title":"Spontaneous pneumomediastinum in the pediatric patient","volume":"210","author":"Abbas","year":"2015","journal-title":"Am. J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/PEC.0000000000000625","article-title":"Pediatric Spontaneous Pneumomediastinum: Narrative Literature Review","volume":"33","author":"Gasser","year":"2017","journal-title":"Pediatr. Emerg. Care"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/1040\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:49:18Z","timestamp":1760140158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/7\/1040"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,13]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["children9071040"],"URL":"https:\/\/doi.org\/10.3390\/children9071040","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,7,13]]}}}