<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-0754</journal-id>
<journal-title><![CDATA[Nascer e Crescer]]></journal-title>
<abbrev-journal-title><![CDATA[Nascer e Crescer]]></abbrev-journal-title>
<issn>0872-0754</issn>
<publisher>
<publisher-name><![CDATA[Centro Hospitalar do Porto]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-07542020000400196</article-id>
<article-id pub-id-type="doi">10.25753/birthgrowthmj.v29.i4.14106</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[HYPOXEMIA IN AN ADOLESCENT: WHEN THE CAUSE IS BETWEEN THE LINES]]></article-title>
<article-title xml:lang="pt"><![CDATA[HIPOXEMIA NUM ADOLESCENTE: QUANDO A CAUSA ESTÁ NAS ENTRELINHAS]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Tatiana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Loureiro]]></surname>
<given-names><![CDATA[Graça]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guimarães]]></surname>
<given-names><![CDATA[Paulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Entre o Douro e Vouga Department of Pediatrics and Neonatology ]]></institution>
<addr-line><![CDATA[Santa Maria da Feira ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar Universitário de São João Hospital Integrado de Pediatria Department of Pediatrics]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>29</volume>
<numero>4</numero>
<fpage>196</fpage>
<lpage>199</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-07542020000400196&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-07542020000400196&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-07542020000400196&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Spontaneous pneumomediastinum is a rare entity in pediatric age, with multifactorial etiology. A 16-year-old male with multiple allergies (mites, dogs, cats, and grasses), daily smoker (one pack/day for one year), and regular cannabis, cocaine, and amphetamine consumer went to the Emergency Department of the local hospital with cough, dyspnea, chest pain, and fever with 12 hours of evolution. On physical examination, the boy presented facies complaints, polypnea, shortness of breath, extensive subcutaneous emphysema in the cervical region and right hemithorax, and diminished vesicular murmur bilaterally with expiratory wheezing. Chest x-ray was performed, revealing alterations compatible with pneumomediastinum and subcutaneous emphysema in the cervical region. Urine test was positive for tetrahydrocannabinoids. Atopy (IgE levels) study was performed, with positive result, and serological testing was performed for Mycoplasma pneumoniae, showing IgM of 33U/mL and IgG of 25U/mL. In this clinical case, multiple pneumomediastinum triggering/predisposing factors can be identified, including marked smoking habits, acute mycoplasma infection, and inhaled and smoked drug consumption. The aim of this study was to review the pathophysiology/semiology of pneumomediastinum and emphasize the importance of clinical suspicion.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo O pneumomediastino espontâneo é uma entidade rara em idade pediátrica e de etiologia multifatorial. Um adolescente de 16 anos de idade, com história de múltiplas alergias (ácaros, cães, gatos e gramíneas), hábitos tabágicos marcados (um maço/dia há um ano) e consumo de canábis, cocaína e anfetaminas recorreu ao Serviço de Urgência por tosse seca irritativa, dispneia, dor torácica e febre com 12 horas de evolução. Ao exame objetivo, encontrava-se queixoso da fácies, polipneico, com tiragem global e extenso enfisema subcutâneo na região cervical e hemitórax direito e murmúrio vesicular diminuído com sibilos expiratórios bilateralmente. A radiografia torácica revelou alterações compatíveis com pneumomediastino e enfisema subcutâneo na região cervical. A pesquisa de abuso de drogas na urina foi positiva para tetrahidrocanabinóides. O estudo de atopia (imunoglobulina E total e imunoglobulinas especificas) foi positivo e a serologia para Mycoplasma pneumoniae revelou IgM de 33U/mL e IgG de25U/mL. Múltiplos fatores desencadeantes/predisponentes de pneumomediastino podem ser identificados neste caso clínico, nomeadamente hábitos tabágicos marcados, infeção aguda por micoplasma e consumo de drogas inaladas e fumadas. O objetivo deste estudo é alertar para a fisiopatologia/semiologia do pneumomediastino e salientar a importância da suspeita clínica.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[chest pain]]></kwd>
<kwd lng="en"><![CDATA[mycoplasma infection]]></kwd>
<kwd lng="en"><![CDATA[multifactorial etiology]]></kwd>
<kwd lng="en"><![CDATA[spontaneous pneumomediastinum]]></kwd>
<kwd lng="en"><![CDATA[subcutaneous emphysema]]></kwd>
<kwd lng="pt"><![CDATA[dor torácica]]></kwd>
<kwd lng="pt"><![CDATA[enfisema subcutâneo]]></kwd>
<kwd lng="pt"><![CDATA[etiologia multifatorial]]></kwd>
<kwd lng="pt"><![CDATA[infeção por micoplasma]]></kwd>
<kwd lng="pt"><![CDATA[pneumomediastino espontâneo]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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