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Ref Number = PITIKA-ASPR0315
BILATERAL SPONTANEOUS PNEUMOTHORAX IN AN 8-YEAR-OLD CHILD WITH TUBERCULOSIS: A CASE REPORT
Angelina Shinta Aprilia, Eifraimdio Paisthalozie, Dewa Ayu Dini Primashanti Dewi, Japendi R P Saragih
OBJECTIVE: Tuberculosis is one of the causes of secondary spontaneous pneumothorax. This report presents a case of spontaneous pneumothorax in a child with tuberculosis infection.

CASE: An 8-year-old boy presented to the emergency unit with chief complaint of shortness of breath accompanied by sudden right chest pain and non productive cough for the last 3 days. There was no history of trauma. The patient was undergoing the second-month treatment for pulmonary tuberculosis and lymphadenitis. On physical examination, he was undernourished and stunting, vital signs revealed patient had tachycardia, tachypneu and oxygen saturation of 80% in room air. Thoracic examination showed chest wall retraction, hyper-resonant percussion and decreased vesicular sound in the right lung. Chest X-ray showed a right-sided pneumothorax. The patient was given supplemental oxygen through a facemask, a thoracostomy tube insertion connected to a water seal drainage (WSD), supportive therapy and antituberculosis drugs. On the 10th day of treatment, the patient complained of shortness of breath and left chest pain. Chest X-ray examination showed left-sided pneumothorax. A left thoracostomy tube was inserted. The patient was discharged on the 17th day of treatment with clinical improvement without further complications.

CONCLUSION: Pneumothorax, although it is rare, can occur as a result of tuberculosis complications. Spontaneous pneumothorax should be considered in children with tuberculosis infection who show symptoms of shortness of breath and sudden chest pain. Supplemental oxygen, chest tube insertion, supportive therapy, and antituberculosis drugs play an important role in the management of secondary spontaneous pneumothorax caused by tuberculosis infection.
Keywords: spontaneous pneumothorax, tuberculosis infection, tube thoracostomy, antituberculosis drugs
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