Pulmonary Cavity From Mycobacterium malmoense in an HIV-Infected Patient: Complicated by Bronchopleural Fistula

Abstract

We present a case of M. malmoense and HIV co-infection complicated by aspergilloma leading to bronchopleural fistula with intractable pneumothorax and pleural aspergillosis, ultimately requiring surgical intervention. Treatment guidelines for M. malmoense are reviewed, literature regarding M. malmoense and HIV co-infection is reviewed, and the epidemiology of M. malmoense in North America is discussed.

The Radiographic Features of Mycobacterium Malmoense Infection

“…Using CT scan showed multiple with sizes more than 2 cm in 80% of cases. These findings do agree with those of Evans et al [3] who reported 6 cm cavity size in about 50 % of cases.…”

“…Our data showed that M. malmoense caused several pulmonary lesions including emphysema, pleural effusion, and pleural disease. These findings are consistent with previous studies [3]. Using CT scan showed multiple with sizes more than 2 cm in 80% of cases.…”

“…Mycobacterium malmoense is known as a slow-growing nontuberculous mycobacterium (NTM) and leads to human infection mainly among patients who are suffering from cellular immunity conditions [1] Although M. Malmoense mainly causes pulmonary infections, but extra pulmonary infections including cervical lymphadenitis and tenosynovitis are likely to exist [2]. M.malmoense is considered as an atypical mycobacterial strain that has been discovered in Sweden since 1954 [3] although the incidence of M. malmoenseis still rare, it has been shown to increase since the 1980s [4]. It has been noted that the majority of patients with M. malmoense infections have been affected by lung disease that impacts immune system including chronic obstructive pulmonary disease (COPD) [3].…”

“…M.malmoense is considered as an atypical mycobacterial strain that has been discovered in Sweden since 1954 [3] although the incidence of M. malmoenseis still rare, it has been shown to increase since the 1980s [4]. It has been noted that the majority of patients with M. malmoense infections have been affected by lung disease that impacts immune system including chronic obstructive pulmonary disease (COPD) [3]. According to the study of Hoefsloot, the occurrence of infection is significantly associated with contaminated water or soil.…”

“…It is of great importance to manage M. malmoense infections in terms of diagnosis at appropriate time and administration of appropriate treatment [3]. In their study, [5] showed the difficulties in diagnosis of pulmonary infection due to M. malmoense, a matter that impacts the appropriate treatment.…”