Abstract
An 86-year-old man with a nontuberculous mycobacterial infection was re-admitted on an emergency basis to his former hospital due to a tension pneumothorax. Chest drainage was performed, but air leakage from the drainage tube continued. The patient was transferred to our hospital 5 days later. Since his general condition on admission was poor, pleurodesis was initially performed. Though pleurodesis was done four times, the air leakage from the drainage tube continued. Both sputum and pleural fluid cultures grew Mycobacterium intracellulare ; perforation of the middle lobe that had nontuberculous mycobacterial disease was suspected on CT. It was concluded that the pulmonary fistula was located at the middle lobe, and an operation was performed on the 30th day of hospitalization. A lung fistula was seen from an incision on thoracoscopy and was closed using fibrin glue and polyglycolic acid felt. Although pneumothorax complicated by a nontuberculous mycobacterial infection is intractable, surgery should be considered in cases with a fistula detected on imaging.
