Crafty Tuberculous Pleurisy Presented With Hydropneumothorax in a 49-Year-Old Male: A Case Report.

A 49-year-old male presented with acute dyspnea and hydropneumothorax. Imaging and biopsy confirmed pleural tuberculosis. Despite atypical features and no risk factors, anti-tuberculosis therapy led to rapid improvement. This case highlights the diagnostic challenge of distinguishing tuberculosis-related hydropneumothorax from necrotizing bacterial pneumonia and empyema in the presence of complex radiological findings.