large pulmonary bullae, resulting from tuberculosis, in the context of extensive pneumothorax caused by a penetrating chest wound

Pulmonary bullae typically occur either idiopathically or in the context of chronic obstructive pulmonary disease and pulmonary infections. clinical manifestations of pulmonary bullae include cough, shortness of breath, and chest pain. in some cases, they may be asymptomatic. differentiating between pneumothorax and pulmonary bullae can be challenging when they coexist. therefore, obtaining a detailed patient history, conducting a physical examination, performing laboratory tests, and utilizing radiology studies are essential diagnostic tools that should be employed simultaneously. in this case report, we present a patient who developed a wide pneumothorax due to a penetrating chest wound caused by a knife. initially, the large lung cavity, which had already formed due to tuberculosis, was misdiagnosed as a loculated pneumothorax.