Mycobacterium abscessus subsp. abscessus empyema complicated with subcutaneous abscess

Area of Science:

• Infectious Diseases
• Surgical Pathology
• Thoracic Surgery

Background:

• Empyema and pneumothorax caused by Mycobacterium abscessus complex infections are rare.
• Subcutaneous abscesses following surgical intervention for these conditions have not been previously reported.

Observation:

• A 75-year-old female patient presented with Mycobacterium abscessus subsp. abscessus (M. abscessus subsp. abscessus)-associated empyema and pneumothorax.
• Following surgical treatment including decortication and fistulectomy, the patient developed M. abscessus subsp. abscessus-induced subcutaneous abscesses.
• The abscesses occurred subsequent to thoracentesis/drainage procedures.

Findings:

• A successful treatment outcome was achieved through a combination of surgical care, thermal therapy, and multidrug chemotherapy.
• This case highlights the development of subcutaneous abscesses as a potential complication after surgery for M. abscessus subsp. abscessus-related thoracic infections.

Implications:

• An early and comprehensive multidisciplinary approach is crucial for managing complex cases of M. abscessus subsp. abscessus-associated empyema with subcutaneous abscess formation.
• This case expands the understanding of potential complications associated with Mycobacterium abscessus infections in the thoracic cavity.
• Effective management strategies may involve integrating surgical, antimicrobial, and physical therapies.