As Dr. Filice correctly pointed out, video-assisted thoracic surgery is now the accepted definitive treatment for primary spontaneous pneumothorax (PSP) complicated by bilateral pneumothorax, recurrent pneumothorax, and persistent air leak, and for selected cases of secondary pneumothorax. As thoracic surgeons and strong proponents of video-assisted thoracic surgery for the treatment of PSP,5 we are particularly familiar with the indications for surgery. However, as we have discussed in our article, the pneumothorax secondary to SARS may represent a distinct clinical condition, and is certainly unlike conventional PSP. Barring the nightmare of a recurrent SARS epidemic, there are insufficient clinical data to suggest what the optimal management strategy is for patients with SARS-related pneumothorax. Our limited experience thus far demonstrates that in six patients, nonsurgical management offered symptomatic relief with no adverse effect on their final clinical outcomes.