A case of pulmonary mycobacterium intracellulare infection complicated with pneumothorax and pleurisy

A 74 year-old female complaining of increased cough and sputum was admitted to our hospital on June 14th 2004. She had been diagnosed as Mycobacterium intracellulare (M. intracellurare) infection since 2002 and had been treated from March to October 2003 in the Department of General Medicine in our hospital. Chest CT on admission showed diffuse small nodular shadows in the lung, a cavity, pneumothorax, and pleural effusion in the right lung. The sputum smear was positive for acid-fast bacilli and sputum PCR examination was positive for M. intracellulare. She was diagnosed as the recurrence of non-tuberculous mycobacterium (NTM) infection and treatment of NTM infection was started. No other infections were suspected and the pneumothorax and pleural effusion gradually improved with the treatment. We concluded that the pneumothorax and pleural effusion were caused by NTM infection. Since pneumothorax is an extremely rare complication in NTM infections we thought it is worth-while to report our case.