Endobronchial Mycobacterium Avium-Intracellulare Infection in Lung Transplant Recipients

Endobronchial Mycobacterium avium-intracellulare (MAI) infection has been described in immunocompromised patients but is rare among transplant recipients. We present a case of a 48-year-old male with a history of coal miners' pneumoconiosis who underwent bilateral lung transplantation. Ten months post-transplant, despite normal spirometry and absence of respiratory symptoms, routine surveillance bronchoscopy revealed multiple endobronchial polypoid lesions. Biopsy demonstrated non-necrotizing granulomatous inflammation, with cultures confirming MAI infection. This case underscores the importance of maintaining a high index of suspicion for atypical infections like MAI in lung transplant recipients, even in the absence of overt clinical symptoms. This case's unique presentation adds to our understanding of potential post-transplant complications and may help clinicians recognize similar presentations in the future.