Pulmonary aspergillosis is uncommon in people living with HIV (PLHIV), and pneumothorax complicating invasive pulmonary aspergillosis (IPA) is exceptionally rare, with few reported cases and generally poor outcomes. We report the case of a 30-year-old man newly diagnosed with HIV infection who developed recurrent right-sided pneumothorax secondary to IPA. The diagnosis was supported by chest CT findings, bronchoalveolar lavage galactomannan positivity, and compatible clinical features. The patient received voriconazole and chest drainage, resulting in a favorable clinical course. This case underscores the importance of considering IPA in PLHIV with persistent respiratory symptoms and highlights that early antifungal therapy combined with appropriate supportive management can significantly improve prognosis.
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