[A case of pulmonary Mycobacterium scrofulaceum infection presented as pleurisy]

A 68-year-old man was referred to our hospital for further examination of pleurisy. Before this admissions, he was diagnosed as having tuberculous pleurisy initially and later as having pleurisy due to SLE in another hospital. He was administered anti-tuberculous medicine including INH, RFP and EB empirically, and later prednisolone and azathioprine. Despite of these medications, there was no improvement. After admission to our hospital, positive results for acid fast bacilli were obtained from both sputum and pleural fluid, and they were identified as Mycobacterium scrofulaceum. He was treated successfully with the combination of INH, RFP, EB plus SM and CAM. The expectoration of M. scrofulaceum was ceased after 4 months of treatment. The common lesion of non-tuberculous mycobacterium is found in the lung. A non-tuberculous mycobacterium infection might accompany with pleural involvement or pleurisy. Thus in case of pleural diseases, non-tuberculous mycobacterium should also be included among differential diagnosis.