Pulmonary Mycobacterium fortuitum Infection Associated With Achalasia Treated With Peroral Endoscopic Myotomy Alone: A Case Report.

Pulmonary infection caused by Mycobacterium fortuitum is uncommon and often occurs in patients with underlying conditions such as achalasia. We report a 50-year-old man with achalasia who developed persistent pulmonary consolidation associated with M. fortuitum. His respiratory symptoms fluctuated in parallel with gastrointestinal symptoms, suggesting chronic aspiration. Histopathological findings and sputum culture supported the diagnosis of nontuberculous mycobacterial disease. Peroral endoscopic myotomy (POEM) was performed to treat achalasia, resulting in marked clinical and radiological improvement without antimycobacterial therapy. This case highlights the importance of addressing underlying diseases in the management of pulmonary nontuberculous mycobacterial infection.