We present a case of spontaneous pneumomediastinum in a person with hypoxemia and dyspnea caused by vigorous cough. The entity of spontaneous pneumomediastinum is unfamiliar and is considered rare. Nasal voice is an uncommon sign of that entity. The dyspnea after exposure to substance inhalation and cough can be caused by different mechanisms such as toxic effects to the lungs and esophagus, or perforation of the trachea, which were not found in our patient.
