Silicosis with Bilateral Spontaneous Pneumothorax in Rajasthan

BACKGROUND AND AIMS: Silicosis is an occupational lung disease caused by inhalation of crystalline silica. People working in occupations like sandblasting, surface drilling, tunnelling, silica flour milling, ceramic making are predisposed to develop silicosis. Unilateral spontaneous pneumothorax is a pleural complication that can develop in such cases. Our aim is to see the prevalence of bilateral pneumothorax in silicosis in Rajasthan and associated predisposing factors. METHODS: Fifty patients of silicosis prospectively reviewed by historical, clinical evaluation, and radiological evidence with increased dyspnea and chest pain in 1 year were included in the study. In all patients, chest X-ray was done immediately. Sputum for acid fast bacilli was done in all cases. RESULTS: Cough and shortness of breath were most common symptoms and present in all cases. All cases were smokers. Chest radiograph revealed reticulonodular density with B/L pneumothorax in all patients. Tube thoracostomy was done in all cases except one in which conservative management was done. CONCLUSIONS: Cases with silicosis can develop complications like tuberculosis, lung cancer, progressive massive fibrosis, cor pulmonale, broncholithiasis, or tracheobronchial compression by lymph nodes. Pleural involvement in silicosis is rare. Spontaneous pneumothorax is a pleural complication that can develop in such cases. Usually in silicosis pneumothorax is unilateral. We report here an original article with silicosis who presented with bilateral spontaneous pneumothoraxes occurring simultaneously. The rarity of its clinical presentation in the form of bilateral simultaneous spontaneous pneumothorax combined with the typical clinical and radiological features of silicosis will make us to report this article.