Tuberc Respir Dis.  2010 Oct;69(4):279-283. 10.4046/trd.2010.69.4.279.

A Case of Pulmonary and Endobronchial Mycobacterium avium Infection Presenting as an Acute Pneumonia in an Immunocompetent Patient

• Lee YJ
• Kim DH
• Yoon KH
• Kim MY
• Jung SW
• Lee BK
• Kim YJ

• KMID: 2114622
• DOI: http://doi.org/10.4046/trd.2010.69.4.279

Abstract

The global number of Mycobacterium avium complex (MAC) pulmonary infection is increasing. Patients with preexisting lung disease or who are immunodeficient are at the greatest risk for developing MAC infection. Endobronchial lesions with MAC infection are rare in the immunocompetent host. However, there have been an increasing number of reports of an immunocompetent host being afflicted with various manifestations of MAC infection. We report a case of pulmonary and endobronchial MAC infection presenting as an acute pneumonia in a 59-year-old female without preexisting lung disease or immunodeficiency.

Keyword

Mycobacterium avium; Infection; Endobronchial; Pulmonary; Immunocompetent Host

MeSH Terms

Female
Humans
Lung Diseases
Middle Aged
Mycobacterium
Mycobacterium avium
Mycobacterium avium Complex
Pneumonia

Figure

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  Figure 1 Initial chest X-ray shows infiltrations with nodular densities in left middle and left lower lung (A). Chest CT scan shows left pleural effusion, multifocal consolidation and nodular lesion with cavitation in left lung field (B).

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  Figure 2 After 10 days of admission, aggravated infiltration of left lung is noted in chest radiograph (A) and bronchoscopy shows hyperemic irregular mucosal lesion in left main bronchus and left upper lobar bronchus (B).

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  Figure 3 Microscopic finding of chronic granulomatous inflammation suggesting mycobacterial infection (H&E stain, ×100).

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  Figure 4 Chest X-ray, performed at 6 months after sputum culture conversion, shows resolution of pulmonary infiltration with reduced left lung volume (A) and bronchoscopy demonstrates improvement of mucosal lesions with narrowing of left upper and lower bronchial lumens (B).

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