<?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>2307-3349</journal-id>
<journal-title><![CDATA[Revista de salud publica del Paraguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. salud publica Parag.]]></abbrev-journal-title>
<issn>2307-3349</issn>
<publisher>
<publisher-name><![CDATA[INSTITUTO NACIONAL DE SALUD - MSP Y BS]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-33492021000100107</article-id>
<article-id pub-id-type="doi">10.18004/rspp.2021.junio.107</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Neumomediastino y neumopericardio espontáneo en paciente con COVID-19; reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Spontaneous pneumomediastin and pneumopericardium in patients with COVID-19; case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[Domingo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rolón]]></surname>
<given-names><![CDATA[Ángel R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rios-González]]></surname>
<given-names><![CDATA[Carlos Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Víctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud y Bienestar Social Hospital General de Luque ]]></institution>
<addr-line><![CDATA[Luque ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Previsión Social Hospital Central Servicio de Cardiología]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional de Caaguazú Facultad de Ciencias Médicas Dirección de Investigación]]></institution>
<addr-line><![CDATA[Coronel Oviedo Caaguazú]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario San Lorenzo  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>11</volume>
<numero>1</numero>
<fpage>107</fpage>
<lpage>111</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-33492021000100107&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-33492021000100107&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-33492021000100107&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: El neumomediastino y neumopericardio espontáneo en pacientes con COVID-19 pueden presentarse de manera inusual, y causar una evolución clínica tórpida. Presentamos el primer reporte clínico del Paraguay de una paciente con neumomediastino y neumopericardio asociado a neumonía por COVID-19.  Presentación del caso: Paciente de 39 años, con neumonía por COVID-19, presentó disnea y dolor de tórax persistente y una evolución clínica tórpida, fue valorada al día veinte y seis de su evolución por especialista en neumología constatándose en los controles tomográficos seriados del pulmón la presencia de aire en mediastino y pericardio que habían pasado desapercibido en los controles primarios. Se instauró un tratamiento médico conservador y sintomático con buena respuesta y evolución favorable.  Discusión: El neumomediastino y neumopericardio espontáneo puede ser causado por una rotura alveolar debido a susceptibilidad de la misma, por la tormenta de citocinas que es común en COVID-19, así el aire puede disecar y discurrir la vaina peri-bronquio vascular y acceder al mediastino u otros espacios, pudiendo presentarse en cualquier estadio de la enfermedad, por lo que los controles tomográficos seriados y correctamente analizados son cruciales para su detección.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Spontaneous pneumomediastinum and pneumopericardium in patients with COVID-19 may occur unusually and cause a torripid clinical evolution. We present paraguay's first clinical report of a patient with pneumomediastinum and pneumopericardium associated with COVID-19 pneumonia.  Case presentation: 39-year-old patient with COVID-19 pneumonia had dyspnoea and persistent chest pain and a torrid clinical evolution, was valued at day twenty-six of its evolution by pneumology, with a presence of air in mediastinum and pericardium at primary controls by initial treating physicians. Conservative and symptomatic medical treatment was instituted with good response and favorable evolution.  Discussion: Spontaneous pneumomediastinum and pneumopericardium can be caused by alveolar rupture due to alveolar susceptibility by the cytokine storm common in COVID-19, thus the air can dissociate and drain the vascular peribronchial sheath and access the mediastinum or other spaces, being able to occur at any stage of the disease, so the serial and correctly analyzed tomographic controls are crucial for its detection.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[neumomediastino]]></kwd>
<kwd lng="es"><![CDATA[neumopericardio.]]></kwd>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[pneumomediastinum]]></kwd>
<kwd lng="en"><![CDATA[pneumopericardium.]]></kwd>
</kwd-group>
</article-meta>
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