Fatal Spontaneous Pneumothorax in Acute Silicosis

Silicosis is a preventable occupational lung disease that can present in chronic, accelerated or acute forms. While chronic silicosis is a known risk factor for spontaneous pneumothorax, this complication is rarely reported in acute silicosis and can be life-threatening. We report an autopsy of a 40-year-old male with acute silicosis who died following a recurrent right-sided spontaneous pneumothorax. He had worked in a glass manufacturing facility with intense silica dust exposure for one year and had a prior episode of pneumothorax due to suspected silicosis eight months before his death. Post-mortem examination revealed a right tension pneumothorax with complete collapse of the right lung, extensive fibrosis in both lungs and ruptured subpleural bullae. Histopathology confirmed acute silicosis with classic silicotic nodules. This case underscores that even acute silicosis can lead to fatal spontaneous pneumothorax, although such complications are more typically associated with chronic silicosis. It highlights the importance of early recognition of pneumothorax in silicosis patients and reinforces the need for stringent occupational dust control and health surveillance to prevent silicosis and its severe complications.