A 40-year-old man presented with an eight day history of left-side pleuritic chest pain and dyspnea. Chest examination revealed decreased air entry at the left lung. Chest X-ray examination revealed a large pneumothorax and a chest tube was successfully placed. Two hours after the procedure, auscultation revealed crackles over the left lung and oxygen saturation was 88% on room air. Chest radiography was repeated and showed a fully expanded left lung with alveolar-interstitial infiltrates.