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An infant (<12 months) presented with a several-day history of fevers, malaise, and progressive respiratory distress associated with a worsening cough and subjective wheezing. His caretakers reported that he had previously been evaluated for mild reactive airway disease initially noted several months prior that had failed to respond to symptomatic treatment with an albuterol nebulizer. Over the several days preceding presentation, his baseline wheezing and work of breathing had acutely increased. Of note, a twin sibling also had symptoms of an upper respiratory illness. His birth history was uneventful, and no further pertinent data were elicited during the initial evaluation.
Rozycki S, Spellman J, Brigger MT. A Child With Pneumomediastinum. JAMA Otolaryngol Head Neck Surg. 2014;140(1):77-78. doi:10.1001/jamaoto.2013.5810