Pneumothorax during Bronchoalveolar Lavage

A man in his seventies who was being treated for bacterial pneumonia showed no signs of improvement. Thus, bronchoscopy was performed to investigate the cause of pneumonia. Midazolam and fentanyl infusions and localized lidocaine were administered, and the patient developed cough. After two infusions of 50 mL of normal saline into the right lower lobe bronchus, the right lung lobe was observed, and the bronchoscope was taught to exit the bronchus. Chest radiography and chest computed tomography revealed a right pneumothorax. The pneumothorax resolved with oxygen therapy, and the patient recovered from pneumonia. Although pneumothorax is a rare complication of bronchoalveolar lavage, we halted the procedure and conducted sedation assessment when the patient experienced a severe cough.