Thoracoscopic pericardial fenestration for effective long-term management of non-tuberculous mycobacterium pericarditis.

The long-term consequences of non-tuberculous mycobacterium pericarditis with pericardial effusion after fenestration have not been described. We encountered a case of non-tuberculous mycobacterium pericarditis in a 59-year-old woman with an underlying collagenosis. Repeated drainage was required because of rapid reaccumulation of the effusion. To definitively control the effusion, pericardial fenestration was performed by video-assisted thoracoscopic surgery. Chest radiography performed 6 years postoperatively showed no accumulation of pericardial or pleural fluid. The patient required careful follow-up and, to date, the pulmonary non-tuberculous mycobacterium (NTM) infection has been successfully suppressed by continuous antibiotic therapy. Pericardial fenestration with antibiotic therapy was an appropriate treatment for recurrent effusion in this case of NTM pericarditis.