Spontaneous Pneumomedistinum in Pneumocystis Pneumonia and Acquired Immunodeficiency Syndrome

Pneumomediastinum is defined as air within the mediastinal cavity, and is usually accompanied by subcutaneous emphysema. It is a relatively uncommon and infrequently reported entity, specifically in patients with AIDS. Reported is a 39-year-old male with chest pain and radiologic findings of tension pneumomediastinum, prompting emergent surgical consultation for decompression. Due to the patient's hemodynamic stability, a conservative approach of observation was employed. Over the following days the patient's pneumomediastinum decompressed naturally into the neck and eventually resolved. Radiographic studies are invaluable in diagnosing and following individuals with pneumomediastinum, but tension pneumomediastinum by radiologic evidence alone is not an indication for surgical intervention.