Welcome to the Medical Science Case Reports
Aim of the Journal
MSCR is an Open Access, peer-reviewed online journal, which aims at contributions advancing health professional education and coverage of original case reports from all medical specialties. MSCR will expand medical knowledge and thus... read more
Aim of the Journal
MSCR is an Open Access, peer-reviewed online journal, which aims at contributions advancing health professional education and coverage of original case reports from all medical specialties. MSCR will expand medical knowledge and thus may be used for teaching and research purposes. MSCR focuses on unusual as well as common (but educational) clinical scenarios.
Editorial and Linguistic Support
Case reports are often first publications in early academic career. MSCR makes it possible for authors to submit ready-to-review manuscripts and provides a unique option for authors who need further editorial and linguistic support as well as guidance in finalizing their case reports.
Viki Kumar, Keerat Rai Ahuja, Fnu Anila, Mohammad Aurangzeb, Theo Trandafirescu
(Department of Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, Jamaica, USA)
Med Sci Case Rep 2017; 4:34-36
Spontaneous pneumothorax may be primary or secondary. There are many causes of secondary spontaneous pneumothorax. Spontaneous pneumothorax in association with scleroderma has been rarely reported.
CASE REPORT: A 41-year-old man presented to the emergency department with sudden-onset dyspnea for 1 day. He denied having chest pain, palpitations, trauma, or other symptoms. Physical exam included mild tachycardia, tachypnea, Raynaud’s phenomenon, and sclerodermal skin changes on extremities, face, and trunk. Lab data included anti-topoisomerase >8 and antinuclear antibody (1: 2560). A chest x-ray revealed a large left pneumothorax with marked compression of the lung field and right-sided tracheal deviation. The patient’s past medical history included 1 year of severe progressive sclerosis, recurrent pneumothorax on right side status post chest tube placement, multiple bronchoscopies, right-sided video-assisted thoracoscopic surgery for persistent air leak, and muscle-sparing thoracotomy with right upper lobectomy. This time, the pneumothorax had recurred on the left side. A chest tube was inserted, resulting in lung expansion with symptom resolution. A post-chest tube CT scan chest showed severe paraseptal and centrilobular emphysematous changes with biapical bullous changes marked in the left apex. Within 3 days, the patient had another episode of dyspnea, with a chest x-ray showing recurrent left pneumothorax. Manipulating and changing the chest tube did not bring any improvement, so a blood patch pleurodesis was done. No recurrence was noted in the next 4 weeks.
CONCLUSIONS: Physicians should consider pneumothorax as one of the potential complications in patients with chronic scleroderma with underlying pulmonary fibrosis and sub-pleural cysts.
Keywords: Pneumothorax, Pulmonary Fibrosis, Scleroderma, Diffuse