A less common symptom of nontuberculous mycobacterial infection is pleuritis. There was a wide range in the clinical course and a significant death rate, as demonstrated by case reports and tiny case series. For a study, researchers sought to characterize the features of the patients, the clinical presentation, and the results of NTM pleural infections.

A thorough analysis was done of NTM pleural infection cases from 1980 to 2021 that were reported in papers with PubMed indexes.

It was discovered and examined that there were 206 cases of NTM pleural infections. Cases involving men made up 58% of all cases. It was 57.5 years on average (range 9–87 yrs). Immunosuppression affected 43% of patients, chronic lung disease affected 43%, and neither immunosuppression nor chronic lung disease affected 32% of patients. In addition to the pleural infection, 67% of patients also had a pulmonary NTM infection, and another extrapulmonary site of NTM infection was present in 18 instances. Pleural infection was the only sign of NTM illness in 29% of patients. Mycobacterium avium complex made up the majority of the isolated mycobacteria (65%). In addition to anti-NTM treatment, 53% and 26% of patients needed pleural effusion drainage and surgical intervention to cure the infection, respectively. Pneumothorax occurred in 40% of patients, empyema struck 16%, and broncho-pleural fistula occurred in 16.5%. The death rate was reported to be 24%.

Immunocompetent and immunosuppressed patients with or without chronic lung illness or concomitant NTM pulmonary infection may develop NTM pleural infections. In addition to anti-NTM treatment, the infections had a poor prognosis and a significant risk of consequences that called for surgical operations.

Reference: resmedjournal.com/article/S0954-6111(22)00301-8/fulltext