# A Case of Nontuberculous Mycobacterial Pulmonary Disease Complicating Massive Pulmonary Embolism

## TL;DR

A man developed a rare lung infection caused by non-tuberculosis mycobacteria two years after being treated for a severe blood clot in his lung.

## Contribution

This case suggests a possible link between chronic pulmonary embolism and the later development of nontuberculous mycobacterial disease.

## Key findings

- The patient was diagnosed with a large pulmonary embolism and treated with anticoagulants.
- Two years later, he developed Mycobacterium avium infection in the same lung area.
- The authors suggest that chronic pulmonary embolism may predispose to nontuberculous mycobacterial disease.

## Abstract

A 39‐year‐old man presented with fever and dyspnoea for 1 week. Imaging suggested bacterial pneumonia with infiltrates in the right lung. However, the symptoms persisted despite antibiotics. Bronchoscopy revealed coagulation necrosis, and enhanced computed tomography identified a large thrombus in the right pulmonary artery, leading to a diagnosis of pulmonary infarction. The patient was treated with direct oral anticoagulants. Two years later, new nodular lesions with cavities were observed in the upper lobe of the right lung. Bronchoscopy revealed a
Mycobacterium avium
infection. We hypothesise that nontuberculous mycobacterial (NTM) pulmonary disease may complicate chronic pulmonary embolism.

We report a rare case of non‐tuberculous mycobacterial disease 2 years after treatment for pulmonary embolism. If a persistent cough or sputum is present after pulmonary embolism, it may be necessary to consider the possibility of NTM pulmonary disease.