A 56- year- old man, a never smoker, presented to the emergency department with a 3- day history of right- sided chest pain—treated outside with anal-gesics—and he developed gradual- onset… Click to show full abstract
A 56- year- old man, a never smoker, presented to the emergency department with a 3- day history of right- sided chest pain—treated outside with anal-gesics—and he developed gradual- onset swelling of face, neck, chest and abdomen for 1 day. He also had a history of productive cough and fever in the past month; there was no history of bouts of vomiting, recent trauma, surgery or any lung diseases. Examination revealed crepitus suggestive of subcutaneous emphysema. Chest X- ray shows pneumothorax with bilateral extensive subcutaneous emphysema extending from neck to abdomen. He high- oxygen; of consolidation and cavities (double sputum examination
               
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