CASE REPORTS SPONTANEOUS HEMOPNEUMOTHORAX—WITH REFERENCE TO THE USE OF STREPTOKINASE AND STREPTODORNASE *

SPONTANEOUS or idiopathic hemopneumothorax is thought to be an unusual and rare occurrence. A review of the literature discloses that there have been about 120 cases recorded. Pitt and Rolleston are usually given credit for pub-lishing the first two comprehensive case reports in 1901.x Each author inde-pendently reported a case of fatal spontaneous hemopneumothorax. Hartzell in 1942 collected 40 cases and added four of his own.1 Eidinger and Rubin in 1952 reviewed the literature and found 56 additional cases and added three of their own.2 In addition to these 103 cases there have been some 17 cases re-ported in the past two years.8"9 Whereas recovery is usually the rule in simple spontaneous pneumothorax, the mortality rate of spontaneous hemopneumothorax is said to approach 25 per cent, with death usually occurring during the first 24 to 48 hours.8*4 The prog-nosis is excellent provided the patient survives the acute episode. However, blood in the pleural space introduces the possibility of an inexpansible lung because of the deposition and organization of fibrin. A decortication then usu