Rare case of spontaneous simultaneous extensive subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum and pneumorrhachis.

A 12-year-old boy who was diagnosed with precursor B-cell acute lymphoblastic leukaemia developed a cough and coryza on day 8 of induction. Subsequent throat swab revealed infection with respiratory syncytial virus. He remained well and proceeded with the planned lumbar puncture and administration of intrathecal methotrexate under general anaesthetic. He represented with sudden onset of severe chest and upper back pain radiating to his neck with associated nuchal rigidity. His cough had persisted and intermittently aggravated the …