<![CDATA[Hemopneumothorax usually occurs following trauma, whereas spontaneous hemopneumothorax associated with pleurosilicosis is extremely rare. We report the case of a 23-year-old man who presented with shortness of breath and right-sided chest pain. He had worked in the steel-cutting section for eight months, during which he was exposed to steel-cutting dust daily without wearing a mask. Chest X-ray showed an air-fluid level in the right hemithorax, and pleural fluid analysis revealed a pleural fluid hematocrit greater than 50% of the peripheral blood hematocrit, confirming hemopneumothorax. The patient underwent chest tube insertion and received a packed red blood cell (PRBC) transfusion. After several days, the right lung had fully re-expanded, and pleural fluid drainage became minimal, allowing chest tube removal. Contrast-enhanced chest computed tomography (CT) revealed a pulmonary nodule in the right lung. The Nucleic Acid Amplification Test (NAAT) for Mycobacterium tuberculosis performed on sputum was negative. Pleural fluid mineral analysis revealed a silica concentration of 268.68 ppm (SiO₂). Based on these findings, the patient was clinically diagnosed with pleurosilicosis associated with spontaneous right-sided hemopneumothorax. This case highlights pleurosilicosis as a rare occupational condition associated with spontaneous hemopneumothorax. It emphasizes the importance of thoroughly investigating the underlying cause, including occupational silica exposure, to ensure accurate diagnosis and appropriate management.]]>
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