Clinical analysis of patients with pulmonary nontuberculous mycobacterial disease complicated by pneumothorax.
OBJECTIVE
We clarified the clinical characteristics of patients with pulmonary nontuberculous mycobacterial (NTM) disease complicated by pneumothorax.


METHODS
We retrospectively selected 220 patients who satisfied the diagnostic criteria for NTM disease proposed by the American Thoracic Society (ATS). Nine patients with pulmonary NTM disease were complicated with pneumothorax. We investigated the patients' background, laboratory findings, radiological findings, treatment and prognoses.


RESULTS
There were nine patients, including six men and three women, with a mean age of 73.2 years. Seven patients had underlying respiratory diseases such as chronic obstructive pulmonary disease (COPD) excluding pulmonary NTM disease. The causative microorganisms was Mycobacterium avium in four patients, M. intracellulare in four patients, and M. kansasii in one patient. Regarding the radiological findings, pneumothorax was recognized in the right lung in five patients, in the left lung in three patients, and in both lungs heterogeneously in one patient. Although most patients exhibited multiple cavities and extensive lesions over the unilateral lung fields, three patients were simultaneously diagnosed with pulmonary NTM disease at the onset of pneumothorax. As for treatment, thoracic drainage was performed in seven patients, while one patient was advised only to rest and one patient required both thoracic drainage and surgery. The responses to the treatment was poor in each case, and five patients died due to pneumonia or heart failure.


CONCLUSIONS
In this study, the rate of pneumothorax complications in the patients with pulmonary NTM disease (4.1%) was higher than that of other reports. The responses to treatment, and prognoses were poor due to the presence of other complications.
Department of Respiratory Medicine, Kawasaki Medical School, Japan.
Yoshihiro
Y
Kobashi
Keiji
K
Mouri
Yasushi
Y
Obase
Shigeki
S
Kato
Mikio
M
Oka
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000382:microbiology; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000382:microbiology; D019909:Mycobacterium kansasii; D011030:Pneumothorax / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies