Section of Clinical Medicine, Department of Clinical and Experimental Medicine, University Hospital St Anna, University of Ferrara, 44100 Ferrara, Italy.
Section of Infectious Diseases, Department of Clinical and Experimental Medicine, University Hospital St Anna, University of Ferrara, 44100 Ferrara, Italy.
J Med Microbiol. 2011 Sep;60(Pt 9):1375-1378. doi: 10.1099/jmm.0.024737-0. Epub 2011 Apr 1.
Mycobacterium fortuitum is a non-tuberculous mycobacterium that can cause pneumonia, abscess and empyema in subjects with predisposing lung diseases. However, pleurisy with effusion is rare. Herein, we report the case of a 74-year-old immunocompetent female patient without apparent risk factors, who suffered haemorrhagic pleural effusion as the main clinical manifestation. Pleural nodules were detected by computed tomography scan, and microbiological analysis revealed M. fortuitum in the absence of other pathogens. The patient was treated with ceftriaxone and ciprofloxacin, and full recovery ensued in 4 weeks. To our knowledge, this is the first reported case of haemorrhagic pleural effusion in an immunocompetent patient without underlying diseases. Although non-tuberculous mycobacterial infections are rarely accompanied by pleural involvement, M. fortuitum should be considered in such cases, especially when microbiology fails to detect the usual pathogens, and when the clinical picture is unclear.
偶然分枝杆菌是一种非结核分枝杆菌，可使肺部疾病易感人群发生肺炎、脓肿和脓胸。然而，并发胸腔积液则较为少见。在此，我们报告了一例 74 岁免疫功能正常的女性患者，该患者无明显的危险因素，以血性胸腔积液为主要临床表现。胸部计算机断层扫描发现有胸膜结节，微生物分析显示存在偶发分枝杆菌，而无其他病原体。该患者接受头孢曲松和环丙沙星治疗，4 周后完全康复。据我们所知，这是首例无潜在疾病的免疫功能正常患者并发血性胸腔积液的报告。虽然非结核分枝杆菌感染很少伴有胸膜受累，但在这种情况下应考虑到偶发分枝杆菌，特别是当微生物学未能检测到常见病原体且临床表现不明确时。
