Pneumothorax secondary to pulmonary tuberculosis (PTB) is a well known complication, particularly in patients with advanced disease. In this study we were able to demonstrate the association between PTB and pneumothorax at our national TB referral hospital.

Methods A retrospective study was performed reviewing patients at the sole national referral center for TB in Iran from 2003 to 2008. Personal characteristics, type of disease and patients, clinical and radiological manifestations, the surgical intervention, and the outcomes were retrieved and analyzed by chi-squared test, Fishers Exact Test, and T-test. The study included 53 TB patients with pneumothorax in the experimental group which was compared to the control group consisting of 106 confirmed TB cases without pneumothorax.

Results Of the 53 total cases of TB with pneumothorax, 34(64.2%) were male . The mean age was 33.5 years (Range: 14-76 years). In total, 36(67.9%) patients were new TB cases without any history of previous TB. Development of pneumothorax was not significantly associated with gender difference, smoking, or drug use (P>0.05). Pneumothorax was found to be significantly more common among patients aged less than 50 years (P<0.001). In terms of radiological manifestations, 20(37.7%)) cases had cavitary lesions, while pulmonary infiltration and effusion were present in 19(35.8%)) and 17(32.1%)) patients respectively. Notably, having a cavitary lesion was significantly higher among patients with pneumothroax (P=0.006) by chi-sq test. Overall, 47(88.6%)) were relieved with chest tube insertion while the others were only observed. All these values of the experimental group were compared to the control group of 106 cases.

Conclusion In patients less than 50 years of age or with cavitary lesions, worsening of the respiratory condition should prompt consideration of pneumothorax. However, further studies with larger sample sizes are crucial, particularly in order to determine the risk factors and prognosis associated with pneumothorax.