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We report a rare case of pulmonary infection with Mycobacterium kansasii complicated by pneumothorax and multiple large nodules in both lungs. A 68-year-old man presented with sudden right chest pain and dyspnea. He was diagnosed with pneumothorax on the right side and immediately treated by insertion of a chest tube and drainage. After admission, the pneumothorax was cured, but a high fever continued. A chest x-ray and computed tomography scan showed multiple large nodules with and without cavities in both lungs. We suspected malignant disease, inflammatory granulomatosis, or pneumomycosis and subsequently performed broncho berscopy. The results of a transbronchial lung biopsy indicated caceous necrosis surrounded by epithelioid cells, without forming distinct granulomas on histology, and the results of acid-fast bacilli smear tests were positive. Mycobacterium could not be detected by polymerase chain reaction. Because the patient’s condition was poor, we started him on anti-Mycobacterium therapy : rifampin, isoniazid, and ethambutol. His condition subsequently improved. Bacterial culture con rmed the presence of M. kansasii, so the antibiotic therapy was continued. The patient’s temperature decreased to below 37°C, and the nodules in his lungs reduced in size. In this atypical case of M. kansasii infection, the patient presented with severe symptoms. Broncho berscopy enabled prompt diagnosis and early treatment.

A Case of Pneumothorax Complicated by Multiple Large Pulmonary Nodules Due to <i>Mycobacterium Kansasii</i> Infection