Niitsu Takayuki, Kuge Tomoki, Fukushima Kiyoharu, Matsumoto Yuki, Abe Yuko, Okamoto Masashi, Haduki Kako, Saito Haruko, Nitta Tadayoshi, Kawano Akira, Matsuki Takanori, Motooka Daisuke, Tsujino Kazuyuki, Miki Keisuke, Nakamura Shota, Kida Hiroshi, Kumanogoh Atsushi
Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center, Osaka, Japan.
Front Med (Lausanne). 2021 Nov 24;8:797171. doi: 10.3389/fmed.2021.797171. eCollection 2021.
is a rare species among rapidly growing mycobacteria, and pleurisy is very rare. Here, we report for the first time, an immunocompetent patient with pleurisy caused by . The patient had no history of immunodeficiency and no recurrence of lung cancer after surgery. However, 8 months after surgery, he developed a new lung shadow and pleurisy. Although whole-genome analysis of the colony cultured from the patient's pleural fluid revealed , we could not identify it in time, resulting in a poor outcome. pleurisy in this case might have occurred via a bulla rupture of the lung lesion because computed tomography of the patient's chest showed pneumothorax and a lung lesion in contact with thoracic cavity. This case emphasized that nontuberculous mycobacterial pleurisy should be considered in the differential diagnoses of pleural effusion even in immunocompetent patients. Advancement of comprehensive and rapid analyses of genomic data from clinical specimens will lead to better treatment strategies.
是快速生长分枝杆菌中的罕见菌种,胸膜炎非常罕见。在此,我们首次报告一例免疫功能正常的患者因 导致的胸膜炎。该患者无免疫缺陷病史,术后肺癌未复发。然而,术后8个月,他出现了新的肺部阴影和胸膜炎。尽管对患者胸腔积液培养的菌落进行全基因组分析显示 ,但我们未能及时鉴定出来,导致预后不良。该病例中的胸膜炎可能是由于肺部病变的肺大疱破裂引起的,因为患者胸部的计算机断层扫描显示有气胸和与胸腔接触的肺部病变。该病例强调,即使在免疫功能正常的患者中,非结核分枝杆菌胸膜炎也应在胸腔积液的鉴别诊断中予以考虑。临床标本基因组数据综合快速分析的进展将带来更好的治疗策略。