Persistent pneumomediastinum in interstitial fibrosis associated with rheumatoid arthritis - Treatment with high-concentration oxygen

We present a case of persistent spontaneous pneumomediastinum precipitated by an upper respiratory infection in a patient with interstitial fibrosis a ssociated with rheumatoid arthritis who was receiving chronic corticosteroi d treatment. The persistent nature of the mediastinal emphysema over 2 mont hs eventually required treatment with high concentrations of inhaled oxygen that resulted in rapid resolution of the pneumomediastinum without recurre nce over 6 months of follow-up. This case, along with others in the medical literature, emphasizes the need for early use of high-concentration inhale d oxygen in the treatment of pneumomediastinum in high-risk patients, such as those with connective tissue disorders.