Pulmonary tuberculosis presenting as tension pneumothorax

Although detection of spontaneous pneumothorax during evolvement active pulmonary tuberculosis is not uncommon, presentation of pulmonary tuberculosis as tension pneumothorax is rare. There is limited literature regarding pneumothorax complicating pulmonary tuberculosis. Pneumothorax due to tuberculosis can be managed by intercostal drainage in the majority; only a minority needs surgical intervention. Many patients need intercostal drainage for a prolonged period. We report a patient presenting with a tension pneumothorax who was found to have active pulmonary tuberculosis. His pneumothorax was managed successfully with prolonged intercostal drainage. Lessons we learnt during the management of this patient is discussed.