title: Mycobacterium fortuitum thoracic empyema: A case report and review of the literature.
abstract: Mycobacterium fortuitum is a rapidly growing nontuberculous mycobacterium. This microorganism is an uncommon etiological agent of lung lesions; among lung lesions caused by M. fortuitum, thoracic empyema is particularly rare. A 61-year-old man who had been treated for chronic hypercapnic respiratory failure with noninvasive ventilation was admitted because of breathing difficulty and was found to have M. fortuitum thoracic empyema. He improved after the administration of amikacin, imipenem/cilastatin, and clarithromycin following sulfamethoxazole/trimethoprim and clarithromycin. This is the first report of M. fortuitum thoracic empyema in a patient without human immunodeficiency virus infection. The thoracic empyema may have developed via a pulmonary fistula in this case. This case highlights the fact that we must be aware of the possibility of M. fortuitum thoracic empyema, especially in patients with M. fortuitum lung infection and treatment with noninvasive ventilation. Multidrug therapy may be effective and important to the resolution of M. fortuitum thoracic empyema.
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Japan. Electronic address: fu_rinkazan0202@yahoo.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tomii
mesh_terms: D000583:Amikacin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D015377:Cilastatin / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D017291:Clarithromycin / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D016724:Empyema, Pleural / Q000150:complications / Q000382:microbiology* / Q000628:therapy*; D006801:Humans; D006935:Hypercapnia / Q000150:complications / Q000628:therapy; D015378:Imipenem / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019907:Mycobacterium fortuitum; D063087:Noninvasive Ventilation; D013420:Sulfamethoxazole / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D015377:Cilastatin; D015378:Imipenem; D000583:Amikacin; D000077728:Cilastatin, Imipenem Drug Combination; D017291:Clarithromycin; D013420:Sulfamethoxazole
keywords: Mycobacterium fortuitum; Noninvasive ventilation; Pulmonary fistula; Thoracic empyema