GENERALIZED INTERSTITIAL EMPHYSEMA AND SPONTANEOUS PNEUMOTHORAX

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Abstract
In the recent epidemic of influenza and bronchopneumonia at Camp Lewis, extensive subcutaneous and interstitial emphysema has occurred in nine patients as a complication of bronchopneumonia. The clinical picture of this emphysema, extending up over the neck, face and scalp, and down over the chest and trunk to the pelvis, and even to the external genitalia, is of such rarity and interest that the cases are here reported. Spontaneous pneumothorax has developed in two patients having extensive bronchopneumonia. That there is a relationship between these two conditions and that they are produced by similar pathologic processes has seemed likely. One case, in fact, presented, at different times, both of these complications. In this paper we are presenting an explanation of the mechanics of these unusual complications. In each instance, the diagnosis of our cases of bronchopneumonia has been corroborated by roentgenography, and, in fatal cases, by necropsy. Early in the

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