ABSTRACT
A preadolescent female presented to the emergency department with an acute asthma exacerbation. Chest radiograph and computed tomography scan showed extensive pneumomediastinum with a small pneumopericardium without a distinct source for this air leak. The patient was admitted for noninvasive monitoring, analgesia, and high concentration oxygen. Serial chest radiographs showed marked improvement following high concentration oxygen, and she was discharged on hospital day 3. Spontaneous pneumomediastinum and pneumopericardium are rare complications of asthma that can often be managed conservatively but should be considered on the differential for this patient population, and may be a complication of COVID-19.
ABSTRACT
Aspirin overdose is still a common cause of presentation to the emergency department and is commonly seen in the setting of one-time, accidental or intentional ingestion of large amounts of salicylate-containing compounds, though can occur with long-term ingestion of super-therapeutic doses of medications. Salicylate toxicity has a predictable progression from early respiratory alkalosis to late metabolic acidosis. We present the case of a 14-year-old girl who intentionally ingested a handful of Aspirin and despite appropriate therapy, developed transient proximal tubule dysfunction. This case highlights the need for a change in the short-term medical management of children presenting with salicylate toxicity.
