Tension pyopneumothorax

Abstract

A 62-year-old man presented to the emergency department (ED) with severe shortness of breath. He had developed a fever and worsening shortness of breath over the preceding 3 days. He had been bed ridden since an ischaemic stroke 6 months previously. On examination he had jugular vein engorgement and there were hyperinflation, absence of breath sounds and a tympanic percussion noted on the right side of the chest.