Infect Chemother.  2004 Dec;36(6):381-385.

A Case of Mycobacterium avium Pulmonary Disease with Massive Pleural Effusion in an HIV-negative, Nonimmunosuppressed Patient: Using PCR-Restriction Fragment Length Polymorphism Assay

• Kim SS
• Rhie EJ
• Ko GJ
• Choi HS
• Oh HE
• Kim JM
• Lee KS

Abstract

The Mycobacterium avium complex (MAC) comprises slow-growing mycobacteria that is ubiquitous in the environment and capable of infecting diverse species with consequences ranging from asymptomatic infection to clinically significant and even fatal disease. Especially, basal pleural disease is infrequently found in immunocompetent person. We report a very rare case of M. avium pleuritis with massive pleural effusion without any predisposing conditions. A previously healthy 36-year-old man was admitted to our hospital because of generalized malaise, low-grade fever, and right pleuritic chest pain of 5 days' duration. Chest X-ray showed mottled infiltration in the right upper lung zone with minimal right pleural effusion which was exudate with lymphocyte-dominance. The pleural effusion progressively increased without responding to anti-tuberculosis treatment. Afterwards M. avium was identified from the pleural effusion using PCR-Restriction Fragment Length Polymorphism Assay(PCR-RFLP). The treatment regimen was changed to rifampine, ethambutol, clarithromycin and streptomycin afterwhich the patient recovered.

Keyword

Mycobacterium-avium complex; Pleural effusion; Restriction Fragment Length Polymorphism Assay

MeSH Terms

Adult
Asymptomatic Infections
Chest Pain
Clarithromycin
Ethambutol
Exudates and Transudates
Fever
Humans
Lung
Lung Diseases*
Mycobacterium avium Complex
Mycobacterium avium*
Mycobacterium*
Pleural Diseases
Pleural Effusion*
Pleurisy
Rifampin
Streptomycin
Thorax
Clarithromycin
Ethambutol
Rifampin
Streptomycin