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Soft plaque in a girl's thigh

The chest X-ray showed left-sided cervical subcutaneous emphysema, extensive pneumomediastinum and pneumopericardium with air beneath the heart. Viral-induced wheeze is a common problem in childhood, with nearly a third of children having a wheezy episode before their third birthday. Simultaneous pneumomediastinum and pneumopericardium have been described in case studies as potential complications of childhood asthma and infant viral bronchiolitis. One case series reported these radiological changes as a complication associated with H1N1 infection in healthy children. By reporting this case, we intend to raise the readers’ awareness that simple viral-induced wheeze can occasionally be associated with extensive air leak.