A 72-year-old man received rifampicin, ethambutol and sitafloxacin to treat clarithromycin (CAM)-resistant Mycobacterium avium complex (MAC) lung disease. He was admitted because of fever. Pneumothorax and pleural effusion were present in the right lung, and a new consolidation appeared in the right upper lobe. Based on positive culture of the pleural effusion for CAM-resistant M. avium and findings on chest computed tomography, he was diagnosed with pleurisy due to M. avium, with rupture of the subpleural lung parenchymal lesion into the pleural space. Additional treatment with streptomycin (SM) improved the patient's high-grade fever. SM might be effective for pleurisy caused by CAM-resistant MAC lung disease.
Keywords: Mycobacterium avium complex; clarithromycin; drug resistance; pleurisy; streptomycin.
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