title: [An elderly case with nontuberculous mycobacteria acompanied by unilateral massive pleural effusion following the video-assisted thoracic surgery (VATS) for lung cancer].
abstract: We report an elderly case with nontuberculous mycobacteria (NTM). Four years after left lung upper lobectomy due to lung cancer by the video-assisted thoracic surgery (VATS), an 81 year-old patient complained of general fatigue and appetite loss. Although he did not exhibit fever or respiratory tract symptoms, a Chest X ray film revealed unilateral massive pleural effusion in the left lung. NTM (Runyon classification type II) was grown in the sputum culture. Neither mycobacterium tuberculosis DNA nor M. avium-intracellulare complex DNA was detected by polymerase chain reaction. The pleural effusion adenosine deaminase (ADA) activity was 127.6U/l. NTM was considered as the most probable diagnosis. After admission his condition and appetite improved. Chest computed tomography (CT) scan showed reduction of left pleural effusion, but another pulmonary nodule lesions were sustained. Although the abnormal findings on chest CT did not totally resolve, we did not prescribe antituberculosis drugs, based on the comprehensive assessment of his NTM disease state. The pathogenesis and diagnosis of HTM in elderly cases was discussed.
authors.affiliation: Department of Geriatric Medicine, Division of Aging Science, Graduate School of Medicine, The University of Tokyo.
authors.forename: Michiko
authors.initials: M
authors.lastname: Matsukawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Teramoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Masato
authors.initials: M
authors.lastname: Eto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hanaoka
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Ohike
authors.forename: Masahiro
authors.initials: M
authors.lastname: Akishita
authors.forename: Yasuyoshi
authors.initials: Y
authors.lastname: Ouchi
mesh_terms: D000369:Aged, 80 and over; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D009164:Mycobacterium Infections / Q000150:complications*; D010996:Pleural Effusion / Q000209:etiology*; D011013:Pneumonectomy; D011183:Postoperative Complications; D020775:Thoracic Surgery, Video-Assisted