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’Pulmonary tuberculosis presenting as massive spontaneous pneumomediastinum and subcutaneous emphysema’
  1. Avinash Anil Nair1,
  2. Leena RV2,
  3. Devasahayam Jesudas Christopher3
  1. 1 Respiratory Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2 Radiology, Christian Medical College and Hospital, Vellore, India
  3. 3 Pulmonary Medicine, Christian Medical College and Hospital, Vellore, India
  1. Correspondence to Dr Avinash Anil Nair, Respiratory Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India; avinash444{at}hotmail.com

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A 56-year-old man, a never smoker, presented to the emergency department with a 3-day history of right-sided chest pain—treated outside with analgesics—and he developed gradual-onset swelling of face, neck, chest and abdomen for 1 day. He also had a history of productive cough and fever in the past month; there was no history of bouts of vomiting, recent trauma, surgery or any lung diseases. Examination revealed crepitus suggestive of subcutaneous emphysema. Chest X-ray shows (figure 1A–E) right pneumothorax with bilateral extensive subcutaneous emphysema extending from neck to abdomen.

Figure 1

(A) Frontal chest radiograph demonstrates right-sided pneumothorax (thin white arrow), streaks …

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Footnotes

  • Contributors AAN: design and preparation of manuscript and image. LRV: radiological diagnosis, image and legends. DJC: review of manuscript and final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.