Mycobacterium abscessus Empyema in an Immunocompromised Patient: A Case Report

Abstract

Thoracic empyema caused by rapidly growing mycobacteria in an immunocompetent patient is rarely reported. A 70-year-old man initially complained about intermittent chest tightness and dull pain at the right chest wall. The patient was diagnosed with and treated for bacterial pneumonia in a community hospital. Anti-tuberculosis agents were given in our ward because of a positive acid-fast stain finding in the sputum. During hospitalization, right thoracic empyema developed, and the pathogens from the sputum and pleural effusion were identified as Mycobacterium abscessus. Decortication with chest tube drainage was performed and intravenous cefoxitin, amikacin, plus klaricid therapy was administered for 3 weeks. The patient was continually monitored in our outpatient department, and was maintained in a stable condition with oral-form antibiotics (klaricid, ofloxacin and doxycycline). This case demonstrates that Mycobacterium abscessus is a pathogen that can cause thoracic empyema in Taiwan, especially in immunocompromised patients.