Simultaneous spontaneous bilateral pneumothoraces in an asthmatic.

The occurrence of simultaneous spontaneous bilateral pneumothoraces is a very rare event. We present a case of a 14-year old asthmatic female patient who presented to the emergency room for routine treatment. While receiving nebulizations, she suddenly developed supraclavicular fullness with crepitus. Further examination revealed a clinical diagnosis of bilateral pneumothoraces. Although this phenomenon is more commonly associated with patients on mechanical ventilation, this case illustrates that physicians must be cognizant of this unique presentation in order to initiate early and aggressive lifesaving therapy. With rapid bilateral needle thoracocentesis followed by placement of bilateral thoracostomy tubes, the patient recovered well. In this report, we also attempt to briefly review the possible pathophysiology of this form of spontaneous pneumothorax.