Case Report DOI 10.3349/ymj.2010.51.6.980 pISSN: 0513-5796, eISSN: 1976-2437 Yonsei Med J 51(6):980-983, 2010 Successful Treatment of Mycobacterium celatum Pulmonary Disease in an Immunocompetent Patient Using Antimicobacterial Chemotherapy and Combined Pulmonary Resection Hee-Jung Jun,1 Nam Yong Lee,2 Jhingook Kim,3 and Won-Jung Koh1 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, 2Department of Laboratory Medicine, and 3Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Received: January 20, 2009 Revised: March 3, 2009 Accepted: March 26, 2009 Corresponding author: Dr. Won-Jung Koh, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3429, Fax: 82-2-3410-6956 E-mail: wjkoh@skku.edu ∙The authors have no financial conflicts of interest. © Copyright: Yonsei University College of Medicine 2010 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non- Commercial License (http://creativecommons.org/ licenses/by-nc/3.0) which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Mycobacterium celatum is a nontuberculous mycobacterium that rarely causes pulmonary disease in immunocompetent subjects. We describe the successful treatment of M. celatum lung disease with antimicobacterial chemotherapy and combined pulmonary resection. A 33-year-old woman was referred to our hospital with a 3-month history of a productive cough. Her medical history included pulmonary tuberculosis 14 years earlier. Her chest X-ray revealed a large cavitary lesion in the left upper lobe. The sputum smear was positive for acid-fast bacilli, and M. celatum was subsequently identified in more than three sputum cultures, using molecular methods. After 1 year of therapy with clarithromycin, ethambutol, and ciprofloxacin, the patient underwent a pulmonary resection for a persistent cavitary lesion. The patient was considered cured after receiving 12 months of postoperative antimycobacterial chemotherapy. There has been no recurrence of disease for 18 months after treatment completion. In summary, M. celatum is an infrequent cause of potentially treatable pulmonary disease in immunocompetent subjects. Patients with M. celatum pulmonary disease who can tolerate resectional surgery might be considered for surgery, especially in cases of persistent cavitary lesions despite antimycobacterial chemotherapy. Key Words: Nontuberculous mycobacteria, Mycobacterium celatum, lung disease, surgery INTRODUCTION Nontuberculous mycobacteria (NTM) are ubiquitous organisms that are increa- singly recognized as important causes of chronic pulmonary infection in non- immunocompromised individuals.1 Mycobacterium avium complex (MAC) and Mycobacterium abscessus constitute the most commonly encountered causes of NTM lung disease in Korea,2 and several other NTM have been identified as pathogens.3,4 Mycobacterium celatum was first described in 1993 as a new species with a mycolic acid pattern that closely resembled Mycobacterium xenopi (xenopi-like), although it was biochemically indistinguishable from MAC.5 M. celatum is an 980 Yonsei Med J http://www.eymj.org Volume 51 Number 6 November 2010