Pulmonary tuberculosis and secondary spontaneous tension pneumothorax in HIV patient: case report

Abstract

Tuberculosis remains as one of the top 10 infectious diseases causing mortality worldwide. In year 2022, Tuberculosis has caused an estimated 1.30 million deaths with 1.13 million of death caused by tuberculosis alone, while 167000 cases in TB-HIV coinfection. Secondary Spontaneous Pneumothorax has been well known as a complication of Tuberculosis, although the incidence is quite rare, it could be life threatening especially if the pneumothorax progress to tension pneumothorax. Patient, male 19 years old came to the emergency room with a sudden shortness of breath for 3 hours prior to hospital admission. X-ray thorax examination showed collapse of the right lung with hyperlucent avascular findings on the right lung, which suggest secondary spontaneous tension pneumothorax. He was treated with chest tube insertion and WSD placement, 2 hours after WSD placement, he became pulseless. ACLS protocols were given and unfortunately, we were unable to achieve ROSC on him. Tuberculosis remains one of the deadliest infection diseases, but can still be treated with the DOTS regimen. Some condition can make tuberculosis difficult to treat, such as immunodeficiency patient like HIV/AIDS. Spontaneous Pneumothorax has been well known as a complication of tuberculosis, although the incidence rate of pneumothorax in tuberculosis are quite low, however it could be life-threatening if it develops into a tension pneumothorax, especially in the settings of advanced stage HIV patients. Spontaneous pneumothorax can be fatal especially when it develops to tension pneumothorax. Further research is needed to know what population who are at risk of developing pneumothorax.