Unexpected Primary Spontaneous Pneumothorax in a Non-smoking Patient After Blowing Out Birthday Candles.

Primary spontaneous pneumothorax (PSP) is defined as the presence of air in the pleural cavity in the absence of underlying pulmonary disease. It predominantly affects young, tall, slim males, who are often smokers. However, it can also occur in healthy non-smokers without comorbidities. Sudden respiratory efforts, although rarely reported, may act as triggering factors. We report the case of a 20-year-old non-smoking man with a slender build and no medical history, who experienced acute left-sided chest pain while blowing out birthday candles. Clinical examination revealed subtle signs of pleural air. A chest X-ray confirmed a left-sided PSP without mediastinal shift. Initial conservative management was started, but due to clinical worsening, chest tube drainage was performed. The outcome was favorable, with no recurrence observed after five years of follow-up. This case illustrates an atypical form of PSP occurring in a young, non-smoking, slim individual following a trivial respiratory effort. It highlights the importance of recognizing everyday actions as potential triggers and ensuring appropriate management and long-term follow-up to prevent recurrence.