Mycobacterium intracellulare Pleurisy Identified on Liquid Cultures of the Pleural Fluid and Pleural Biopsy

Abstract

Pleural effusion is a rare complication in non-tuberculous mycobacterial infection. We report a case of Mycobacterium intracellulare pleuritis with idiopathic pulmonary fibrosis in a 69-year-old man presenting with dyspnea. Pleural effusion revealed lymphocyte dominant exudate. M. intracellulare was identified using a polymerase chain reaction-restriction fragment length polymorphism method and liquid cultures of pleural effusion and pleural biopsy. After combination therapy for M. intracellulare pulmonary disease, the patient was clinically well at a 1-month follow-up.

Keywords: Mycobacterium Infections, Nontuberculous; Mycobacterium avium Complex; Pleural Effusion.

Figure 1

Chest X-ray findings. (A) On admission, chest X-ray revealed left pleural effusion with reticular densities in the bibasilar area. (B) At a 1-month follow-up, chest X-ray revealed improvement of left pleural effusion.

Figure 2

High-resolution computed tomography findings. (A) Mediastinal window setting revealed a moderate amount of left pleural effusion with subtle pleural thickening. (B) Lung window setting revealed multifocal, ill-defined, patchy reticular opacities with honeycombing lesions in both lower lobes of the lung.