Pneumothorax induced by Pneumocystis jirovecii( P. jirovecii) pneumonia is often refractory to treatment. A man in his 30's who had malignant lymphoma and received chemotherapy developed P. jirovecii pneumonia. A month after treatment for pneumonia, he developed a secondary pneumothorax. Since drainage was not effective, he underwent right lower lobectomy and bulla resection. Air leakage stopped after surgery but recurred on postoperative day 5. Chest computed tomography showed a new bulla on his right lung. On postoperative day 15, we inserted an endobronchial Watanabe spigot( EWS),and air leakage completely stopped.
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- * He was initially treated with corticosteroids but developed refractory pneumothorax, which made managing the air leakage challenging.
- * The treatment was successfully modified to include mepolizumab, an anti-interleukin-5 therapy, and an endobronchial Watanabe spigot, resulting in the resolution of the pneumothorax and no recurrence of EP post-treatment.
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