Pneumothorax alone, or accompanied by serous fluid, or by pus, is infrequent enough in any single clinic to be of sufficient interest to study and report. In the present case of pyopneumothorax (Case 1) there is added interest on account of the obscured physical signs and symptoms, the unusual partial encapsulation of the pneumothorax, as shown by roentgenogram, and the transmitted cardiac pulsation through the fluid.
In the majority of cases the collapsed lung is easily discernible by Roentgen ray and can be made out by percussion near the mediastinal border, in contrast to the hyperresonant, tympanitic condition of the rest of the chest, and at the base of the pleural cavity the fluid can be easily marked out. In a typical case of pneumothorax, such as is reported here, and which preceded the present case of pyopneumothorax by a few weeks, diagnosis is not a difficult matter. When atypical
JAMES A. HONEIJ. PYOPNEUMOTHORAX AND PNEUMOTHORAXA REPORT OF TWO CASES WITH INTERESTING CLINICAL AND ROENTGENOLOGIC FINDINGS. Arch Intern Med (Chic). 1917;XX(4):629–635. doi:10.1001/archinte.1917.00090040157008