A rare presentation of spontaneous subcutaneous emphysema following Influenza A virus in a young male – A case report

Introduction Spontaneous subcutaneous emphysema (SSE) is the leakage of air into the subcutaneous tissue plain in the absence of external trauma caused by rise of alveolar pressure leading to rupture of alveoli. This case highlights a very rare occurrence of SSE in influenza A viral infection Case presentation We report a 16 year old previously healthy man who presented with sudden onset diffuse chest pain after having two days of fever and cough. On examination he had crepitation in neck and upper chest areas without respiratory compromise. Plane radiography demonstrated extensive subcutaneous emphysema in chest and neck and contrast enhanced computer tomography (CECT) of chest demonstrated subcutaneous emphysema (SE) with normal lung parenchyma. Influenza A H1N1 was positive in his throat swab and mycoplasma infection, COVID and pyogenic infection were excluded. He was treated with oseltamivir and supplemental high flow oxygen via nasal cannula and met with full recovery in seven days. Conclusion This rises the importance of actively looking for the evidence of SE in patients with influenza since mere presence of SE rise the possibility of underlying serous conditions such as pneumomediastinum and pneumothorax. Early detection and treatment with supplemental oxygen helps in spontaneous recovery without needing for invasive interventions.