Spontaneous pneumomediastinum and surgical emphysema presenting as rhinolalia following ecstasy ingestion: a case report

We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use. This case presents a 17-year-old white male experiencing rhinolalia following ecstasy ingestion at a rave. Subsequent chest X-ray revealed extensive surgi...

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Bibliographic Details
Published in:Journal of medical case reports 2024-06, Vol.18 (1), p.306-4, Article 306
Main Authors: Prada, Caterina, Ross, Max
Format: Article
Language:English
Subjects:
Adolescent
Case report
CT imaging
Diagnosis
Diagnosis, Differential
Ecstasy
Ecstasy (Drug)
Electrocardiogram
Electrocardiography
Emphysema, Pulmonary
Humans
Male
Mediastinal Emphysema - chemically induced
Mediastinal Emphysema - diagnostic imaging
N-Methyl-3,4-methylenedioxyamphetamine - adverse effects
N-Methyl-3,4-methylenedioxyamphetamine - poisoning
Pneumomediastinum
Rhinolalia
Spontaneous pneumomediastinum
Subcutaneous Emphysema - chemically induced
Subcutaneous Emphysema - diagnostic imaging
Surgical emphysema
Tomography, X-Ray Computed
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Summary:We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use. This case presents a 17-year-old white male experiencing rhinolalia following ecstasy ingestion at a rave. Subsequent chest X-ray revealed extensive surgical emphysema, along with a continuous diaphragm sign indicative of pneumomediastinum. Computed tomography confirmed the diagnosis. The patient was managed conservatively with strict monitoring and 6 hourly electrocardiograms. Follow-up computed tomography on day 3 showed resolution of pneumomediastinum and surgical emphysema, and the patient was safely discharged. Notably, the patient experienced a temporary rhinolalia during the acute phase, which resolved spontaneously as his condition improved. This case underscores the importance of considering spontaneous pneumomediastinum and surgical emphysema in the differential diagnosis of young individuals presenting with acute symptoms after drug use.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-024-04618-9