Case Report Simultaneous Bilateral Primary Spontaneous Pneumothorax: A Case Report and a Review of the Literature Jakrin Kewcharoen , 1 Paul Morris, 2 Chanavuth Kanitsoraphan, 1 Hanh La, 3 and Narin Sriratanaviriyakul 3 1 University of Hawaii Internal Medicine Residency Programs, Honolulu, HI 96813, USA 2 Department of Surgery, Te Queen’s Medical Center, Honolulu, HI 96813, USA 3 Department of Internal Medicine, Te Queen’s Medical Center, Honolulu, HI 96813, USA Correspondence should be addressed to Jakrin Kewcharoen; jakrin@hawaii.edu Received 18 November 2018; Accepted 25 December 2018; Published 27 January 2019 Academic Editor: Akif Turna Copyright © 2019 Jakrin Kewcharoen et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Simultaneous bilateral primary spontaneous pneumothorax (SBPSP) is an extremely rare and potentially fatal condition. Patients usually have no relevant medical conditions. Some cases, however, may have certain risk factors such as smoking, being young, and male gender. We reported a case of a healthy young male who presented with BPSP. Case Presentation. A 21-year- old man with a past medical history of well-controlled intermittent asthma presented with acute worsening shortness of breath overnight. Chest X-ray performed showed bilateral large pneumothorax with signifcantly compressed mediastinum. Chest tubes were placed bilaterally with immediate clinical improvement. However, the chest tubes continued to have an air leak without full lungs expansion. Computed tomography scan without contrast of the chest revealed subpleural blebs in both upper lobes. Te patient underwent bilateral video-assisted thoracoscopic surgery (VATS) with apical bleb resection, bilateral pleurectomy, and bilateral doxycycline pleurodesis. Biopsy of the apical blebs and parietal pleura of both lungs were negative for any atypical cells suspicious for malignancy or Langerhans cell histiocytosis. Te patient had been doing well six months following surgery with no recurrence of pneumothorax. Conclusion. SBPSP is a rare and urgent condition that requires prompt intervention. In a young patient without any underlying disease, surgical intervention, such as VATS, is relatively safe and can be considered early. 1. Introduction Pneumothorax is a common medical condition defned by a presence of air or gas in the cavity in the pleural cavity. Te incidence of spontaneous pneumothorax, the term used to call pneumothorax that arises by itself in the absence of trauma, was reported to be 1.2 to 28 cases per 100,000 [1]. Patients with spontaneous pneumothorax can present as either primary or secondary. Te term primary spontaneous pneumothorax is used when there is no relevant medical condition found, although these patients may have certain risk factors, such as smoking, being young, and male gender. In contrast, the term secondary spontaneous pneumoth- orax is used when there is an underlying disease that is associated with the pneumothorax, such as lung tumor or chronic obstructive pulmonary disease (COPD) [2]. On rare occasions, spontaneous pneumothorax can present bilater- ally. Simultaneous bilateral primary spontaneous pneumoth- orax (SBPSP) is an extremely rare presentation found in only 1% of all spontaneous pneumothorax [2]. Tis condition ofen causes signifcant respiratory distress and in some cases progresses to tension pneumothorax or death. Signs and symptoms of the SBPSP can be minimal initially thus requiring physicians to always be suspicious and aware of this disease [3]. Prompt management is needed to exclude tension pneumothorax and relieve the dyspnea. Unlike other types of pneumothorax, surgical intervention is indicated in SBPSP as it leads to better overall outcome compared to tube thoracostomy [1]. In this article, we report a case of a young male with SBPSP who was found to have bilateral lung blebs and eventually underwent bilateral blebs resection and bilateral pleurectomy. Hindawi Case Reports in Pulmonology Volume 2019, Article ID 6583842, 6 pages https://doi.org/10.1155/2019/6583842