Infect Chemother.  2013 Mar;45(1):99-104.

Endobronchial Mycobacterium avium Infection in an Immunocompetent Patient

• Kang SH
• Mun SK
• Lee MJ
• Kim SY
• Choi HG
• Byun J
• Kim CH
• Kim HR
• Cho SY

Abstract

Although Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial (NTM) pulmonary diseases, endobronchial lesions caused by MAC infections are very rare even in an immunocompromised host. Herein, we describe the case of a 59-year-old, HIV-negative and non-immunocompromised woman who developed multifocal pulmonary infiltrations with endobronchial lesion caused by M. avium. Bronchoscopic examination revealed white- and yellow-colored irregular mucosal lesions in the bronchus of the left lingular division. M. avium was identified using sputum culture and bronchial washing fluid culture. Following the recommendations of the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA), the patient was begun on treatment with antimycobacterial drugs. After treatment, pneumonic infiltration decreased.

Keyword

Mycobacterium avium; Immunocompetent host; Nontuberculosis mycobacteria

MeSH Terms

Americas
Bronchi
Communicable Diseases
Female
Humans
Immunocompromised Host
Lung Diseases
Mycobacterium
Mycobacterium avium
Mycobacterium avium Complex
Sputum

Figure

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  Figure 1 Chest radiography (A) and chest CT (B-D) at the initial visit showing multiple pulmonary infiltrates in the left lingular division and left lower lobe.

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  Figure 2 Chest radiography (A) and chest CT (B-D) after 6 months showing aggravation of the multiple pulmonary infiltrates in the left lingular division and left lower lobe.

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  Figure 3 Bronchoscopic view from the bronchus of the left lingular division shows a white- and yellow-colored irregular mucosal lesion.

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  Figure 4 Microscopic finding of chronic granulomatous inflammation with caseous necrosis. (A) H&E staining at 100× magnification; (B) H&E staining at 400× magnification; arrow, caseous necrosis; arrowhead, epithelioid histiocyte.

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