Simultaneous bilateral spontaneous pneumothorax is a rare condition occurring in up to 1.9% of cases of spontaneous pneumothorax.¹ Risk factors include male sex, smoking, height and underlying lung conditions. An increase in the incidence is seen in AIDS patients with underlying pneumocystis carinii infection.² In contrast with a large unilateral pneumothorax, simultaneous bilateral spontaneous pneumothorax presents difficulties in diagnosis from clinical signs alone and definitive diagnosis requires chest radiography.

A 39 year old man self presented to the accident and …