Recurrent Primary Spontaneous Pneumothorax in an 18-Year-Old Man: A Case Report and Review of Considerations for Prophylactic Contralateral Pleurodesis.

Primary spontaneous pneumothorax (PSP) is defined as the accumulation of air in the pleural space originating from within the lung parenchyma without preceding trauma, which can lead to a stable or tension pneumothorax. Clinical suspicion is key for diagnosis, with chest radiography serving as the primary diagnostic tool. Management ranges from needle aspiration to tube thoracostomy with consideration of surgical intervention for recurrent cases. We present an 18-year-old African-American man who experienced three episodes of radiography-confirmed PSP occurring over a seven-month period. This case is notable for its recurrent pattern of PSP, including contralateral involvement after unilateral pleurodesis, in an adolescent who is otherwise healthy. This case underscores the challenges posed by idiopathic PSP and the need to evaluate genetic or structural predispositions, while raising the question of whether prophylactic contralateral pleurodesis should be considered in patients with recurrent unilateral PSP. The rarity of such recurrence in adolescents supports further research and development of standardized evaluation algorithms in this population.