Pneumomediastinum as a complication of recreational ecstasy use

Ecstasy recreational use dramatically increased during the last decade in France. Multiples complications associated with ecstasy consumption have been reported. We describe an exceptional case of pneumomediastinum related to ecstasy recreational use. The patient was a 19-year old patient whose medical history was significant for asthma and was a moderate tobacco smoker. He reported regular ecstasy recreational use. He presented at the emergency unit for chest pain and cough, 48 hours after the ingestion of three tablets of ecstasy and the inhalation of three other tablets. Blood pressure was 90/60 mmHg, pulse rate was 120 per minute, respiratory rate was 32 per minute and pulse oximetry was 93%. Neck emphysema was noted. Chest radiograph and scanner diagnosed pneumomédiastinum. Outcome was favorable with symptomatic treatment and the patient was discharged home eight days later. Pneumomediastinum is an exceptional complication after ecstasy recreational use. Physician should be aware of the risk of such event.