Secondary spontaneous pneumothorax in a patient with resistant Mycobacterium abscessus infection and systemic sclerosis-associated interstitial lung disease: A case report

Yoko Nishizawa; Hideki Katsura; Yuka Sasaki; Ryoma Kudo; Aki Kizuki; Ai Horimoto; Motonao Ishikawa; Kae Takagi; Ken Kikuchi; Hiroshi Sakura; Kosaku Nitta; Junichi Hoshino; Tetsuya Ogawa

doi:10.1016/j.rmcr.2023.101941

Secondary spontaneous pneumothorax in a patient with resistant Mycobacterium abscessus infection and systemic sclerosis-associated interstitial lung disease: A case report

Respir Med Case Rep. 2023 Nov 5:46:101941. doi: 10.1016/j.rmcr.2023.101941. eCollection 2023.

Authors

Yoko Nishizawa¹, Hideki Katsura^{1

2}, Yuka Sasaki³, Ryoma Kudo¹, Aki Kizuki¹, Ai Horimoto¹, Motonao Ishikawa¹, Kae Takagi¹, Ken Kikuchi⁴, Hiroshi Sakura¹, Kosaku Nitta⁵, Junichi Hoshino⁵, Tetsuya Ogawa¹

Affiliations

¹ Department of Medicine, Tokyo Women's Medical University Adachi Medical Center, 4-33-1, Kohoku, Adachi-ku, Tokyo, 123-8558, Japan.
² Department of Respiratory Medicine, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
³ Center of Pulmonary Disease, National Hospital Organization Tokyo National Hospital, 3-1-1, Takeoka, Kiyose-shi, Tokyo, 204-8585, Japan.
⁴ Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjyuku-ku, Tokyo, 162-8666, Japan.
⁵ Department of Nephrology, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjyuku-ku, Tokyo, 162-8666, Japan.

Abstract

Mycobacterium abscessus subsp. abscessus (MABA) is refractory and sometimes fatal especially in an immunocompromised patient. Also, MABA-associated pneumothorax is an extremely rare complication. We report a case of MABA pulmonary infection complicated pneumothorax treated successfully. A 69-year-old Japanese female with immunosuppressed systemic sclerosis-associated interstitial lung disease experienced left-sided secondary spontaneous pneumothorax. MABA was detected in the pleural effusion and blood culture. Microbial sensitivity test showed the MABA was sensitive to only amikacin, sitafloxacin, and clofazimine. Combination therapy with these antibiotics including azithromycin achieved remission within three weeks. In the treatment of MABA infection, compliance with microbial sensitivity test is crucial.

Keywords: Clofazimine; Interstitial lung disease; Mycobacterium abscessus; Pheumothorax; Systemic sclerosis.

Publication types

Case Reports