A Case of Spontaneous Mediastinal and Subcutaneous Emphysema in a Patient with HIV-Infected Pneumonia

作者全名："Li, Jun-Chen; Nie, Gang; Dai, Hai-Feng"

作者地址："[Li, Jun-Chen; Nie, Gang] Chongqing Med Univ, Univ Town Hosp, Dept Internal Med, Chongqing 400000, Peoples R China; [Dai, Hai-Feng] Chongqing Med Univ, Affiliated Hosp 1, Dept Infect Dis, Chongqing 400000, Peoples R China"

通信作者："Nie, G (通讯作者)，Chongqing Med Univ, Univ Town Hosp, Dept Internal Med, Chongqing 400000, Peoples R China.; Dai, HF (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Infect Dis, Chongqing 400000, Peoples R China."

来源：CURRENT HIV RESEARCH

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000906946600007

JCR分区：Q4

影响因子：1

年份：2022

卷号：20

期号：6

开始页：479

结束页：484

文献类型：Article

关键词：Human immunodeficiency virus; mediastinal and subcutaneous emphysema; metagenomic next generation sequencing; targeted anti-pathogen therapy; CT; AIDS

摘要："Background: Acquired immunodeficiency syndrome is a chronic infectious disease with high mortality and is caused by the Human Immunodeficiency Virus (HIV). Pneumonia caused by HIV is common, but it rarely causes spontaneous mediastinal and subcutaneous emphysema. Case Presentation: A 21-year-old man with severe pneumonia was hospitalized owing to dyspnea that had been persisting for 1 day; blood test results confirmed HIV infection. Initial chest Computed Tomography (CT) did not reveal mediastinal or subcutaneous emphysema. However, after 21 days of treatment, the patient experienced discomfort in the neck region and experienced the feeling of snowflakes on applying pressure. Chest CT showed mediastinal and subcutaneous emphysema, located in the bilateral cervical roots, anterior upper chest wall, left axillary chest wall, mediastinum, and other parts. Metagenomic Next Generation Sequencing (mNGS) of the sputum and blood samples suggested multiple pathogenic infections. Antiinfection treatment was initiated, and changes in the patient's condition were monitored. The patient's subcutaneous emphysema improved during the follow-up. Conclusion: In HIV-infected patients with sudden mediastinal and subcutaneous emphysema, mNGS can be used to determine the etiological agent during symptomatic treatment. Targeted anti-pathogen therapy is helpful in improving the condition of patients with subcutaneous emphysema."

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