Extensive subcutaneous emphysema and pneumomediastinum after ecstasy ingestion

A Case of Spontaneous Pneumomediastinum Following Ecstasy and Marijuana Use

Spontaneous pneumomediastinum (SPM) is a benign and self-limiting condition more commonly seen in young adults. Radiology imaging of the chest, including X-ray or CT scan, is the gold standard for diagnosis. Ecstasy, also known as 3,4-methylenedioxymethamphetamine (MDMA) is a synthetic amphetamine derivative widely abused for an increased sense of well-being and euphoria. Marijuana is also abused for recreational purposes. SPM has been reported after both Ecstasy and marijuana use. SPM after these illicit drugs abuse usually has a benign and self-limiting course with supportive management. However, it is always important to rule out serious associated conditions like esophageal perforation. Here, we present a 22-year-old male who developed SPM after Ecstasy ingestion and marijuana inhalation.

Spontaneous Pneumomediastinum and Diffuse Subcutaneous Emphysema after Methamphetamine Inhalation

Methamphetamines are commonly abused drugs for their stimulant and euphoric effects. Inhaled and intravenous use may cause damage to the respiratory system. Spontaneous pneumomediastinum is a condition where changes in intrathoracic pressure leads to alveolar rupture and dissection of air along the tracheobronchial tree. Massive subcutaneous emphysema may result from pneumomediastinum which may compromise the central airway. In this case report, we present an unusual case of spontaneous pneumomediastinum and severe subcutaneous emphysema following inhalation of methamphetamine. This case emphasizes the rising concern on the acute respiratory complications of methamphetamine use.

Bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young male patient following MDMA intake

MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is an illicit drug frequently used by young people at parties and 'raves'. It is readily available in spite of the fact that it is illegal.¹ It is perceived by a lot of young people as being 'harmless', but there have been a few high-profile deaths associated with its use.² Known side effects of MDMA include hyperthermia, rhabdomyolysis, coagulopathy and cardiac arrhythmias.³ Rarer side effects include surgical emphysema and pneumomediastinum, which have been better described with cocaine abuse.^4-6 We present a case of bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young man after taking ecstasy.

Spontaneous pneumomediastinum: A rare complication of methamphetamine use

OBJECTIVE

To present an unusual case of spontaneous pneumomediastinum subsequent to recreational amphetamine use.

CASE REPORT

A young African American adult male was admitted to internal medicine service for treatment of rhabdomyolysis secondary to methamphetamine use. On admission, he was complaining of chest pain in addition to nausea and generalized muscle aches. By his second hospital day, chest pain had resolved yet physical exam demonstrated crepitation of the anterior chest and left axilla. Portable chest x-ray revealed subcutaneous emphysema in addition to pneumomediastinum.

CONCLUSION

Spontaneous pneumomediastinum is a rare complication of amphetamine use that is often associated with subcutaneous emphysema and can be diagnosed with chest x-ray. Management is conservative, with observation, pain control, and supplemental oxygen as needed.