A Primary Spontaneous Pneumothorax in Young Woman

Abstract

Primary spontaneous pneumothorax (PSP) occurs in patients without preexisting lung disease and no precipitating event. Risk factors include smoking, age under 40 years, ectomorph body type and family history of PSP. Acute chest pain and shortness of breath are the most frequent symptoms. Pulmonary examination is the most important to clinical diagnosis. We present the case of a patient who consulted in our internal medicine clinic. Complementary information was collected by researching databases on this matter. We describe the case of a 22-year-old javanesse woman with no relevant medical history. The patient presented with sudden onset chest pain and dyspneu since 5 days ago, getting worse with exercise and kneeling potion. The past two days, she can only sleep with sitting position. No fever or cough or PSP in familty history previously. She had recovered from parotitis 3 month s ago. She looked tired, tachypnea and tachicardia, and had a 86% peripheral oxygen saturation. The hemithorax dextra is miss motion, hypersonor, deminished breath sounds. The patient was referred to the emergency department, where additional imaging studies showed an extensive pneumothorax with collapsed right pulmo. She was admitted for tube thoracostomy and water shield drainage immediately. After 5 days, she had a complete pulmonary expansion. The case described a young woman with PSP wihout any risk factor beside history of parotitis. It emphasized the importance of physical examination which can not be replaced by additional and laboratory.