Abstract
BACKGROUND: Pleural involvement by non-tuberculous mycobacteria (NTM), especially NTM empyema in the immunocompetent patient without pulmonary diseases is a rare disease. It is difficult to diagnose with only a few cases of immunodeficient patients in the literature. CASE PRESENTATION: We describe a 63-year-old male with empyema due to NTM and highlight the challenges of diagnosis. CONCLUSIONS: Non-tuberculous mycobacterial infection should be considered as a cause of pleuritis or empyema without pulmonary disease, however it is a real diagnostic dilemma.