Spontaneous Pneumomediastinum as the presenting sign of Mycoplasma pneumoniae infection

Introduction: Spontaneous pneumomediastinum (SP) results from nontraumatic mediastinal air leakage. It is uncommon in children requiring a high index of suspicion. Case Report: A 17-year-old tall thin boy, light smoker, with no history of trauma or lung disease presented to our emergency room with symptoms dominated by chest pain and mild dyspnea. He reported a violent cough event in the previous hours. Pneumomediastinum was suspected considering the presence of subcutaneous air in the supraclavicular region, and was confirmed by chest radiograph, which showed mediastinal air. Serology study was positive for Mycoplasma pneumoniae and therefore a macrolide was added to symptomatic treatment, with a complete recovery. Discussion/Conclusion: SP is a diagnosis to consider when facing an adolescent with acute chest pain. This condition is possibly underdiagnosed, given its benign course and mild symptoms. Smoking acts as a predisposing factor. SP has only exceptionally been described in Mycoplasma infection