RT Journal Article SR Electronic T1 Spontaneous pyohaemothorax in a teenager with von Willebrand disease: a case report and review of literature JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e241613 DO 10.1136/bcr-2021-241613 VO 14 IS 8 A1 Vaishnavi Divya Nagarajan A1 Asha Shenoi A1 Lucy Burgess A1 Vlad C Radulescu YR 2021 UL http://casereports.bmj.com/content/14/8/e241613.abstract AB An 18-year-old man with a history of type 3 von Willebrand disease (VWD) presented with a spontaneous pyohaemothorax. Type 3 VWD may present with both mucocutaneous and deep-seated bleeds, such as visceral haemorrhages, intracranial bleeds and haemarthrosis. There have been very few cases described in children of spontaneous pyohaemothorax. Management of this patient was challenging due to risks of bleeding following surgical drainage, requiring constant replacement with von Willebrand factor concentrate, while monitoring factor VIII levels to balance the risks of thrombosis.