Acute dyspnea revealing Hamman syndrome occurring in the setting of diabetic ketoacidosis: a diagnostic delay in the post-pandemic era

Hamman syndrome is a rare complication of diabetic ketoacidosis (DKA), caused by alveolar rupture leading to spontaneous pneumomediastinum. We report a 44-year-old man who presented with acute dyspnea following several clinic visits where persistent cough was repeatedly attributed to a common cold without physical examination. Computed tomography revealed mediastinal and subcutaneous emphysema, consistent with Hamman syndrome. Laboratory findings showed severe hyperglycemia and ketonuria, suggestive of DKA. The patient improved with insulin infusion, fluid therapy, and supplemental oxygen. This case highlights an important challenge in the post-pandemic era: reduced in-person evaluation and increased reliance on remote consultation may lead to delays in diagnosing metabolic disorders. Sedentary lifestyle associated with prolonged remote working may further obscure early symptoms of diabetes. Clinicians should remain vigilant for DKA and its rare complications when evaluating unexplained dyspnea.