Spontaneous pneumothorax in a patient with tuberculosis-induced destroyed lung successfully treated with autologous blood and minocycline pleurodesis: a case report.

Background: Spontaneous pneumothorax in a tuberculosis-induced destroyed lung is uncommon and challenging, particularly when surgery poses prohibitive risk. Practical, non-surgical strategies that reliably control persistent air leak are therefore needed. Case Description: A 48-year-old woman with prior pulmonary tuberculosis and a destroyed right lung presented with right-sided pneumothorax. On arrival, she maintained adequate oxygenation on room air and did not require supplemental oxygen. Despite appropriate chest drainage, a persistent air leak continued for more than 2 weeks. Chemical pleurodesis was performed via the chest tube using a combined regimen of minocycline 100 mg diluted in 50 mL normal saline plus 50 mL autologous blood (total instilled volume 100 mL). Because leakage persisted, a second pleurodesis with the same regimen was performed 48 hours later. Within 24 hours after the second procedure, the air leak ceased. Follow-up chest radiography confirmed re-expansion, the chest tube was removed on day 21, and the patient was discharged without complications. Outpatient follow-up at approximately 2 weeks, 1 month, and 3 months included chest radiographs at the first two visits; no recurrence was observed, and the patient reported satisfactory daily activity without dyspnea beyond baseline. Conclusions: In high-risk patients with post-tuberculosis destroyed lung and persistent air leak, combined autologous blood and minocycline pleurodesis can provide effective, bedside control and avert surgery. This case details a simple two-step protocol with explicit dosing and timing that may be considered when operative management is unsuitable.