Pleural Effusion/Empyema With Mycobacterium kansasii

Abstract

Mycobacterium kansasii is a nontuberculous mycobacterium that causes pulmonary symptoms, commonly associated with underlying conditions, including malignancy, prior transplant, and HIV. However, rarely does Mycobacterium kansasii present with pleural effusion. We present a case of a 56-year-old female who presented with dyspnea and chest pain, and sputum culture was positive for acid-fast bacilli. A CT scan revealed a left-sided pleural effusion. Based on a thorough review of the literature using Embase and PubMed, we found that only 22 cases of a Mycobacterium kansasii pleural effusion have been reported. We provide a discussion on maintaining a broad differential in the treatment of immunocompromised individuals with Mycobacterium infection.

Pleural infection caused by Mycobacterium kansasii in a patient after lung transplantation

“…Pleural infection due to Mycobacterium kansasii is a rare condition. Twenty-three cases have been reported of this non-tuberculous mycobacterial lung disease (NTM-LD), three cases occurred after solid organ transplantation (two patients after renal transplantation and one patient after lung transplantation) [3] , [4] , [5] .…”

“…When derived from respiratory isolates, criteria for NTM-LD by the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) must be met in order to distinguish colonisation or contaminant from a true pathogen [7] . Pulmonary infections with Mycobacterium kansasii are usually associated with immunosuppression including patients after transplantation, e. g. malignancies, HIV or underlying lung disease [3] . NTM-LD should be diagnosed when NTM-positive patients show pulmonary or systemic symptoms (e.g., dyspnoea, fever, night sweats, weight loss) which correlate with radiographic features on chest radiograph or high-resolution computed tomography (HR-CT) [7] , [8] .…”