A 52-year-old male patien...

A 52-year-old male patient, formerly a smoker and currently working as a carpenter, presented to the Emergency Room with complaints of shortness of breath (SOB) persisting for one week, which has worsened from grade 2 to grade 4, along with a fever for the past two days. The patient has a known history of old Pulmonary Tuberculosis (PTB) treated one year ago, diagnosed radiologically (negative sputum smear and CBNAAT), and had a previous hospitalization for Secondary Spontaneous Pneumothorax (SSP) on the right side three months ago, which was treated with an intercostal chest drain (ICD) in an outside facility. The chest x-ray at the presentation showed a deep sulcus sign on the right hemithorax and multiple infiltrates in the left lung. The patient underwent ICD insertion without complications, resulting in adequate lung expansion. Subsequently, he underwent pleurodesis using Povidone Iodine. It is important to note that SSP has a recurrence rate of 30% after the first episode, 40% after the second episode, and over 50% from the third attack onwards. By performing pleurodesis during the first episode, the patient's subsequent risks and the need for hospitalization could have been reduced. The underlying PTB is also being investigated for any forms of Multi-Drug Resistant (MDR) strains.