Citation Information :
Mohanty V, Mukundan M, Panda PK. ARDS with Concomitant Pneumomediastinum-Pneumothorax Presenting as Platypnoea-Orthodeoxia Syndrome. Indian J Chest Dis Allied Sci 2021; 63 (1):37-40.
Platypnoea-orthodeoxia syndrome (POS) is a rare clinical entity with very few cases reported worldwide. We report a case of a 27-year-old male with a seven-day history of fever, dry cough, and breathlessness; later on, diagnosed to have H1N1 (Swine flu) and acute respiratory distress syndrome. He was put on mechanical ventilation and weaned off in due course. However, he had persistent dyspnoea and desaturation in sitting position that relieved on lying down (platypnoea/orthodeoxia). He was again mechanically ventilated. High resolution computed tomography of chest revealed tension pneumomediastinum and pneumothorax. Computed tomography-guided pigtail drainage of mediastinal air and bilateral intercostal drainage tubes were performed. His symptoms improved immediately. He had no underlying demonstrable cardiac disease. The diagnosis of POS was made due to a high index of clinical suspicion and helped in establishing POS as a presentation of concomitant pneumomediastinum-pneumothorax in this patient. To the best of our knowledge, acute respiratory distress syndrome complicated by concomitant pneumomediastinum-pneumothorax as an extra-cardiac cause of POS has not been reported.
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