Epidural pneumorrhachis, a rare complication of asthma exacerbation

INTRODUCTION An association between pneumorrhachis and asthma exacerbation is uncommon. However, we present a clinical case involving a patient with exacerbated asthma, subcutaneous emphysema, spontaneous pneumomediastinum (SPM), and pneumorrhachis.
CASE STUDY The patient was an 18-year-old male with asthma since childhood who only relied on salbutamol to control his asthma symptoms.
RESULTS The patient suddenly experienced dyspnea, chest tightness, and paroxysmal coughing, which prompted him to visit the emergency department. Upon arrival, subcutaneous emphysema was detected on the face, neck, thorax, and left forearm. Chest X-ray showed air in the mediastinum, neck, left supraclavicular region, and chest, all of which were verified by a computed tomography scan that also revealed air in the epidural region. At the hospital, his treatment focused on preventing asthma exacerbation and managing associated symptoms.
CONCLUSION When a patient has asthma exacerbation that is accompanied by SPM and extensive emphysema, the presence of epidural pneumorrhachis should not be overlooked.

as reported in: J Asthma. 2019 Jan 10 1-4 [Epub ahead of print]