Mycobacterium avium Pleurisy with Bronchopleural Fistula Resulting in Rapidly Progressive Respiratory Failure Diagnosed by Transbronchial Autopsy
Nontuberculous mycobacterial lung disease usually manifests as a chronic pulmonary infection. We herein report a fatal case of Mycobacterium avium pleurisy in a man with a refractory bronchopleural fistula that led to rapidly progressive pneumonia. A post-mortem transbronchial biopsy was performed. Histopathology revealed an acute lung injury pattern and epithelioid granulomas. Variable number tandem repeat analyses and drug susceptibility testing revealed Mycobacterium avium had acquired macrolide resistance during chemotherapy with rifampicin, ethambutol, and clarithromycin. Clinicians should be aware that Mycobacterium avium pleurisy with bronchopleural fistula can lead to fatal pneumonia, especially in patients with persistently positive cultures despite multidrug treatment.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
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| Enthalten in: |
Internal medicine (Tokyo, Japan) - 62(2023), 8 vom: 15. Apr., Seite 1237-1241 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Osaki, Megumu [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Bacterial Agents |
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| Anmerkungen: |
Date Completed 21.04.2023 Date Revised 16.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2169/internalmedicine.9749-22 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM346473209 |
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| 520 | |a Nontuberculous mycobacterial lung disease usually manifests as a chronic pulmonary infection. We herein report a fatal case of Mycobacterium avium pleurisy in a man with a refractory bronchopleural fistula that led to rapidly progressive pneumonia. A post-mortem transbronchial biopsy was performed. Histopathology revealed an acute lung injury pattern and epithelioid granulomas. Variable number tandem repeat analyses and drug susceptibility testing revealed Mycobacterium avium had acquired macrolide resistance during chemotherapy with rifampicin, ethambutol, and clarithromycin. Clinicians should be aware that Mycobacterium avium pleurisy with bronchopleural fistula can lead to fatal pneumonia, especially in patients with persistently positive cultures despite multidrug treatment | ||
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