Spontaneous pneumothorax, pneumomediastinum, and epidural emphysema presenting as neck pain suspicious for meningitis

Pneumomediastinum and epidural pneumatosis are rare findings. Simultaneous occurrence of spontaneous pneumothorax, pneumomediastinum, pneumopericardium, and epidural emphysema is particularly rare. These findings are even more unusual when there is no history of trauma, underlying pathology, or history of asthma. We present a case of a young male who was referred to the emergency department by his primary care physician for rule out meningitis and was found to have all the above-mentioned findings. It is important to recognize the clinical signs and symptoms of air trapping in various tissues and investigate appropriately. This may prevent potentially life-threatening complications. Subcutaneous emphysema, pneumomediastinum, and epidural emphysema associated with spontaneous bilateral pneumothoraces represents an extremely rare presentation.