Mycobacterium xenopi is a
nontuberculous mycobacterium (NTM) that rarely causes
pulmonary disease in
Asia. Here we describe the first case of M. xenopi
pulmonary disease in
Korea. A 66-year-old man was admitted to our
hospital with a 2-month
history of productive
cough and
hemoptysis. His past medical
history included
pulmonary tuberculosis 44 years earlier, leading to a right upper lobectomy.
Chest X-ray upon admission revealed cavitary consolidation involving the entire right
lung. Numerous
acid-fast bacilli were seen in his initial
sputum, and M. xenopi was subsequently identified in more than five
sputum cultures, using molecular
methods. Despite
treatment with
clarithromycin,
rifampicin,
ethambutol, and
streptomycin, the infiltrative shadow revealed on
chest X-ray increased in size. The
patient's condition worsened, and a right completion
pneumonectomy was performed. The
patient consequently died of
respiratory failure on postoperative day 47,
secondary to the development of a late bronchopleural
fistula. This case serves as a reminder to clinicians that the
incidence of NTM
infection is increasing in
Korea and that unusual NTM are capable of causing
disease in non-
immunocompromised patients.