Secondary Spontaneous Pneumothorax Caused by Pulmonary Schistosomiasis

Abstract

Schistosomiasis is an endemic disease commonly found in areas of Africa and the Middle East. It is a prevalent parasitic infection in the southern region of Saudi Arabia and Yemen. The most common species found are Schistosoma mansoni and Schistosoma haematobium. Schistosomiasis can manifest in the urinary bladder, liver, and gastrointestinal system. The occurrence of the infection in the lungs is very rare and usually appears after years of initial infection. We report a case of a 23-year-old Yemeni male who presented to the emergency department complaining of sudden, right-sided chest pain with shortness of breath of one day. Examination and chest X-ray revealed the presence of pneumothorax, and a chest tube was inserted accordingly. As the pneumothorax did not resolve and a continuous air leak was present, the patient was taken to the operation theatre on suspicion of a fistula. The diagnostic procedure found the presence of bullae and patterns of inflammatory infection. A resected lung wedge revealed the presence of Schistosoma eggs, and schistosomiasis was diagnosed. In conclusion, spontaneous pneumothorax secondary to infection can present in young healthy males. Meanwhile, schistosomiasis infection must be kept in mind when dealing with patients coming from endemic areas even if they present with no recent visit to endemic areas.

Parasitic lung diseases

“…Other Schistosoma -associated pulmonary diseases include spontaneous pneumothorax [ 49 ], hydropneumothorax with pleural thickening [ 32 ] and nodular pulmonary lesions [ 50 ]. The latter can be acute in the case of travellers or chronic in residents of endemic areas [ 50 ].…”

Risk factors and clinical features for pulmonary paragonimiasis-associated pneumothorax

“…However, because most patients do not complain of respiratory symptoms, the presence of larvae maturation or migratory phases in the lung is a very uncommon finding [21,23]. Finally, schistosomiasis [24] and amobiasis [25] have been reported as uncommon causes of pneumothorax. The parasitic diseases mentioned above should be considered during the differential diagnosis of pneumothorax, especially in endemic areas.…”