Pulmonary Mycobacterium avium complex infection
Chronic cough and shortness of breath.
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Multiple cavitating lesions within the right lower and middle lobes. Bilateral extensive varicose and traction bronchiectasis with a right middle and lower lobe predominance. Bilateral tree in bud appearance with lower lobe predominance along with multiple small pulmonary nodules.
Pleural scarring and nodularity are likely due to chronic infection.
No pleural effusions.
Prominent but sub centimetre mediastinal lymph nodes.
Acid-fast bacilli detected.
- ANTIGEN TESTING: MPT64 Antigen Identification Test: M.tuberculosis Complex NOT detected.
- NUCLEIC ACID TESTING: M.tuberculosis Complex PCR by GeneXpert: NOT Detected.
- MYCOBACTERIUM CULTURE SCREEN: positive.
MYCOBACTERIAL CULTURE: Mycobacterium avium Complex ISOLATED
This case illustrates advanced changes of MAC in a patient that has been on treatment for a few years, on what difficult response was observed and was multiple relapses of symptoms.