Cough-related spontaneous retropharyngeal emphysema in a pediatric patient with Influenza A infection: a case report

Background: Spontaneous retropharyngeal emphysema (SRE) is a scarce condition in the pediatric population.Clinical case: An 11-year-old boy presented with respiratory distress and cervical pain after a severe cough attack.A cervical examination revealed a marked subcutaneous emphysema.A polymerase chain reaction (PCR) for respiratory viruses was positive for influenza A/H3.A blood culture was obtained and was negative.A chest and a cervical X-ray showed pneumomediastinum and SRE.A computed tomography scan showed a pulmonary condensation on the left lower lobe and ectopic air at the level of the cardioesophageal junction.An upper gastrointestinal series demonstrated the absence of contrast leakage.The patient was managed conservatively with good clinical evolution and resolution of symptoms.Two weeks after the episode, a chest and a cervical X-ray showed almost complete resolution of the SRE and the pneumomediastinum.Conclusions: The exceptional presentation of spontaneous pneumomediastinum in a pediatric patient without asthma underscores the importance of considering SRE in the differential diagnosis of cervical and thoracic ectopic air in the pediatric population.