Background Pneumothorax is a condition where air leaks into the space between the visceral and parietal pleura. Community acquired pneumonia is a rare cause of pneumothorax in children. Pneumothorax can sometimes develop as a complication of pneumonia when infection erodes the distal airway into the pleural cavity causing air leak. If the air leak persists for more than 7 days, then it is termed a persistent air leak. Case Summary A 6‐year‐old South Asian girl presented with right upper and middle lobe pneumonia with empyema, for which a chest tube drain was inserted, which progressed to a persistent pulmonary air leak. Despite initial hospital management, the air leak persisted, necessitating home‐based care with meticulous follow‐up. Later on, after home‐based care, the child improved and the chest tube could be removed without complications. The management of persistent air leak complicated by pneumonia necessitates a multidisciplinary approach. Conclusion This case highlights an innovative approach to managing complex pediatric respiratory conditions outside the hospital setting. The incorporation of domiciliary care introduces a novel dimension. This requires meticulous training of the parents with no medical exposure before monitoring and guiding them via online video and ensuring they adhere to treatment protocols. This report highlights the possibility of conservative domiciliary management for persistent air leak before going into definitive surgery.
Shrestha et al. (2026) studied this question.