# Spontaneous Pneumothorax, Pneumomediastinum, and Pneumopericardium in an HIV Patient With Tuberculosis: A Rare Trio

## TL;DR

This paper reports a rare case of three simultaneous lung-related conditions in an HIV patient with tuberculosis.

## Contribution

The paper presents a unique case of spontaneous pneumothorax, pneumomediastinum, and pneumopericardium in an HIV patient with tuberculosis.

## Key findings

- The trio of pneumothorax, pneumomediastinum, and pneumopericardium is rare and previously unreported in tuberculosis.
- The patient's condition worsened despite treatment, leading to obstructive and septic shock.
- Diagnosis of tuberculosis was confirmed through bronchoalveolar lavage after initial tests were negative.

## Abstract

A trio of spontaneous pneumomediastinum, pneumopericardium, and pneumothorax is a highly unusual presentation. The majority of reported cases are due to trauma, while the remaining cases are iatrogenic. Among infections, this trio has so far been reported in COVID-19 pneumonia and pneumocystis pneumonia in HIV-positive patients. There are case reports on pneumothorax and pneumomediastinum in tuberculosis, but the trio is not reported. Here, we present a case of a recently diagnosed HIV-positive patient with complaints of cough and shortness of breath whose initial workup was negative for Mycobacterium. The patient was, however, started on antitubercular drugs based on clinical radiological evidence. He developed spontaneous pneumothorax, pneumomediastinum, and pneumopericardium, and repeat bronchoalveolar lavage (BAL) came positive for Mycobacterium. The patient, however, could not be revived and succumbed to obstructive and septic shock.