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J Med Microbiol 57 (2008), 664-667; DOI: 10.1099/jmm.0.47574-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Case Report

Mycobacterium chelonae empyema in an immunocompetent patient

Hsiao-Cheng Hsieh1,2, Po-Liang Lu1,3, Tun-Chieh Chen1,3, Ko Chang1,2 and Yen-Hsu Chen1,3

1 Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

2 Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan

3 Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence
Yen-Hsu Chen
d810070{at}cc.kmu.edu.tw

Received 24 August 2007
Accepted 11 January 2008

Thoracic empyema caused by rapidly growing mycobacteria (RGM) and complicated with bronchopleural fistula is rarely reported, especially in immunocompetent patients. A 53-year-old healthy woman presented initially with a productive cough and intermittent fever. The patient received a complete treatment course following an initial diagnosis of pulmonary tuberculosis. After the anti-tuberculosis agents were discontinued, a right thoracic empyema with bronchopleural fistula occurred, and the pathogens from both pus and sputum were identified as Mycobacterium chelonae. Thoracotomy with decortication and wedge resection of the right middle lung was performed, followed by clarithromycin plus ciprofloxacin therapy for 36 months. This patient has not suffered a relapse in the last 3 years. In addition to the experience of successful treatment, this case indicates that RGM such as M. chelonae can emerge as causative pathogens of thoracic empyema, even in healthy persons.

Abbreviations: NTM, non-tuberculosis mycobacteria; RGM, rapidly growing mycobacteria.






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