Not All Infantile Air Leaks Tell the Same Story: A Case Series from South India

Abstract

Spontaneous pneumothorax (SP) in infancy is uncommon and often secondary to underlying infectious, congenital, or neoplastic lung pathology. Clinical presentation may be subtle, and pediatric management strategies are largely extrapolated from adult guidelines. In this case series, five infants aged 2–8 months with spontaneous pneumothorax are presented. Etiologies included viral lower respiratory tract infection in three infants, congenital bullous disease in one, and pleuropulmonary blastoma in the last infant. Two infants were managed successfully with intercostal chest drainage. Three of them required surgical intervention due to persistent air leak or structural lung abnormality, including bullectomy and lobectomy. One infant was diagnosed with Type I pleuropulmonary 
blastoma on histopathology. From these cases, it can be inferred that infantile spontaneous pneumothorax represents a heterogeneous clinical entity. Persistent or recurrent air leak warrants advanced imaging and early surgical evaluation to identify underlying structural or neoplastic causes.