Intrapleural injection of quinacrine for pneumothorax in a child with cystic fibrosis.

Pneumothorax occurs in 2% to 4% of patients with cystic fibrosis following 
rupture of subpleural blebs into the pleural space. Death can occur, 
and recurrences have been reported. Therapeutic procedures include needle aspiration, closed 
thoracotomy drainage, open thoracotomy with pleural scarification, or intrapleural instillation of 
irritants. When injected into the pleural space, the antimalarial drug quinacrine 
hydrochloride evokes an inflammatory response; the resultant fibrosis produces a tight 
adherence of the visceral and pleural surfaces. Quinacrine therapy for pneumothorax 
has been frequently used in adults, but there are few pediatric 
case reports. 