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Endobronchial avium mycobacteria infection in an immunocompetent child

Caroline Perisson1, Nadia Nathan, Briac Thierry

  • 1Pediatric Pulmonology-INSERM UMR S-938, AP-HP Hôpital Armand Trousseau, Paris, France.

BMJ Case Reports
|November 21, 2013
PubMed

Insights

A rare Mycobacterium avium complex (MAC) endobronchial granuloma caused airway obstruction in an infant. Prompt diagnosis and multidrug therapy led to a full recovery, highlighting the importance of recognizing this condition.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Respiratory infections in children require accurate diagnosis.
  • Mycobacterium avium complex (MAC) is an opportunistic pathogen.
  • Endobronchial granulomas can cause significant airway obstruction.

Observation:

  • A 12-month-old boy presented with dyspnea and wheezing.
  • Chest imaging revealed subcarinal adenopathy and a right principal bronchus (RB) nodule.
  • Bronchoscopy identified RB obstruction by granulomas.

Findings:

  • Histopathology confirmed necrotizing granulomatous inflammation.
  • Culture identified Mycobacterium avium complex (MAC).
  • Tests for tuberculosis and immunodeficiency were negative, indicating an immunocompetent host.

Implications:

  • This case highlights MAC endobronchial granuloma as a rare cause of airway obstruction in immunocompetent children.
  • Multidrug therapy (clarithromycin, rifampin, ethambutol) was effective.
  • Early diagnosis and treatment are crucial for favorable outcomes and normalized bronchoscopy.

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