Acute empyema with intractable pneumothorax associated with ruptured lung abscess caused by Mycobacterium avium

Asai, Katsuyuki; Urabe, Norikazu

doi:10.1007/s11748-010-0687-7

Cited by 10 publications

(9 citation statements)

References 10 publications

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“…Such differences might also affect the prevalence of SSP and its clinical features, thus explaining the discrepancies between the results of the present study and those of Brown et al However, the present results suggesting that right laterality is more common in SSP than in PSP are in agreement with those of Brown et al [30]. This result can be explained by the fact that pulmonary emphysema-associated azygoesophageal recess is more common on the right side than on the left, and since pulmonary emphysema is one of the more common underlying diseases in SSP, right laterality is expected to be relatively more prevalent in SSP than in PSP [31]. …”

Section: Discussionsupporting

confidence: 92%

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality

Onuki

Ueda

Yamaoka

et al. 2017

Canadian Respiratory Journal

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Background. Optimal treatment practices and factors associated with in-hospital mortality in spontaneous pneumothorax (SP) are not fully understood. We evaluated prevalence, clinical characteristics, and in-hospital mortality among Japanese patients with primary or secondary SP (PSP/SSP). Methods. We retrospectively reviewed and stratified 938 instances of pneumothorax in 751 consecutive patients diagnosed with SP into the PSP and SSP groups. Factors associated with in-hospital mortality in SSP were identified by multiple logistic regression analysis. Results. In the SSP group (n = 327; 34.9%), patient age, requirement for emergency transport, and length of stay were greater (all, p < 0.001), while the prevalence of smoking (p = 0.023) and number of surgical interventions (p < 0.001) were lower compared to those in the PSP group (n = 611; 65.1%). Among the 16 in-hospital deceased patients, 12 (75.0%) received emergency transportation and 10 (62.5%) exhibited performance status (PS) of 3-4. In the SSP group, emergency transportation was an independent factor for in-hospital mortality (odds ratio 16.37; 95% confidence interval, 4.85–55.20; p < 0.001). Conclusions. The prevalence and clinical characteristics of PSP and SSP differ considerably. Patients with SSP receiving emergency transportation should receive careful attention.

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Section: Discussionsupporting

confidence: 92%

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality

Onuki

Ueda

Yamaoka

et al. 2017

Canadian Respiratory Journal

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“…NTM pleuritis may occur via lymphogenous or hematogenous spread in an immunocompromised situation, such as in case of the acquired immunodeficiency syndrome [14,15] or advanced cancers. However, since NTM is usually less virulent than M. tuberculosis, in most cases, the mechanism of NTM pleuritis was primarily suspected to be the perforation of pulmonary NTM disease or spread of inflammation to the pleura [16,18,19,22,31,32]. Our study revealed that 73% of cases had subpleural cavitation, and most cases were considered to present bronchopleural fistula or pneumothorax according to the radiological findings.…”

Section: Discussionmentioning

confidence: 73%

Clinical Features and Prognosis of Nontuberculous Mycobacterial Pleuritis

et al. 2018

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Background: While nontuberculous mycobacterial (NTM) pleuritis rarely complicates pulmonary NTM infection, high mortality has been reported in case reports and small studies. Objectives: The purpose of this study was to clarify the clinical features and treatment outcomes of pulmonary NTM infection cases accompanied by NTM pleuritis. Methods: Medical records of 1,044 patients with pulmonary NTM disease were retrospectively reviewed to select patients complicated by NTM-proven pleuritis. We investigated clinical characteristics, pathogens, pleural effusion examinations, radiographic findings, treatments, and clinical course of the NTM pleuritis patients. Results: Among 1,044 cases with pulmonary NTM, NTM pleuritis occurred in 15 cases (1.4%). The mean age was 69 years with a performance status of mostly 2 or better (80.0%), and 6 cases (40.0%) were complicated by pneumothorax. Subpleural cavities were radiologically detected in 11 cases (73.3%), and extrapulmonary air-fluid level was detected in 14 cases (93.3%). Eleven patients were treated with combinations of 2–4 antimycobacterial drugs, including clarithromycin, and 2 patients were treated with isoniazid, rifampicin, and ethambutol. Chest tube drainage was performed in 11 cases, and surgical approach was added in 6 cases. The pleural effusion of 2 patients treated with only antimycobacterial medications gradually deteriorated. Two patients died from NTM pleuritis, and 1 patient died from pneumonitis during a mean of 1.8 years of follow-up. Conclusions: Comorbid NTM pleuritis was difficult to treat by medical therapy alone and resulted in a poor prognosis. In addition to antimycobacterial agents, chest tube drainage and surgical procedures in the early stages should be considered to treat NTM pleuritis.

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“…Successful management of MAC-Pleural disease may require a combination of medical and surgical treatment [ [13] , [14] , [15] , [16] , [17] ]. Triple drug macrolide based regimen is less effective in MAC-Pleural disease with a culture conversion rate of 73% compared to 95% in MAC-LD [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A tale of two images: From mycobacterium avium complex-lung disease (MAC-LD) to mycobacterium avium complex-pleural disease

Varkey

Kohal

Barua

et al. 2021

Respiratory Medicine Case Reports

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The typical radiographic presentation for Mycobacterium avium complex lung disease (MAC-LD) is either nodular bronchiectasis or cavitary lung disease. The former is seen most commonly in middle-aged or elderly Caucasian females with the characteristic asthenic phenotype, and the latter in middle-aged male smokers with COPD. We present the case of a young, otherwise healthy woman, with no significant risk factors, who was incidentally found to have MAC-LD with associated bronchiectasis. The patient's treatment and clinical course over a period of 5 years was marred by erratic follow up, intermittent treatment and poor adherence to guideline-based antibiotic therapy. Over this period of time, the patient developed significant worsening of her MAC-LD, macrolide resistance and failure to thrive. Upon presentation 5 years after her initial diagnosis, she had developed MAC-Pleural Disease with an empyema and broncho-pleural fistula. This case illustrates the progression of MAC-LD from nodular bronchiectasis to cavitary disease and pleural involvement leading to clinical deterioration. It highlights challenges related to short and long term management of macrolide resistant MAC-LD and the importance and need for surgical intervention and drainage procedures in patient with MAC-Pleural Disease.

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Acute empyema with intractable pneumothorax associated with ruptured lung abscess caused by Mycobacterium avium

Cited by 10 publications

References 10 publications

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality

Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality

Clinical Features and Prognosis of Nontuberculous Mycobacterial Pleuritis

A tale of two images: From mycobacterium avium complex-lung disease (MAC-LD) to mycobacterium avium complex-pleural disease

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