• Bo-Gun Kho, Young-Ok Na, Hwa Kyung Park, Jae-Kyeong Lee, Hyung-Joo Oh, Ha-Young Park, Tae-Ok Kim, Hong-Joon Shin, Yong-Soo Kwon, Yu-Il Kim, and Sung-Chul Lim.
• Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
• Medicine (Baltimore). 2021 Dec 23; 100 (51): e28342e28342.

RationaleNontuberculous mycobacteria (NTM)-associated pleuritis is a very rare disease. Here, we describe 2 cases of life-threatening Mycobacterium intracellulare-associated pleuritis in immunocompetent hosts.Patient ConcernsA 78-year-old man with sudden onset-onset dyspnea (case 1) and an 80-year-old man with cough, sputum and fever (case 2) presented to our emergency room.DiagnosesBoth the patients were diagnosed with Mycobacterium intracellulare-associated pleuritis.InterventionIn case 1, the patient underwent intubation with mechanical ventilation due to hypoxemic respiratory failure. Daily azithromycin, rifampin and ethambutol, and intravenous amikacin 3 times a week was administered. In case 2, the patient received daily azithromycin, rifampin and ethambutol, and intravenous amikacin 3 times a week.OutcomesIn case 1, after receiving NTM treatment for 14 months, NTM-associated pleuritis was cured, with radiologic improvement. In case 2, however, bronchopleural fistula was developed. Despite tube drainage, air leak continued. The patient refused surgical management and eventually died of respiratory failure.LessonsPleural effusion arising from NTM lung disease located in the subpleural area should be considered a possible cause of NTM-associated pleuritis. Drainage and a multidrug regimen are required to treat NTM, and surgical treatment should be considered when complications occur.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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