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[A case of Mycobacterium avium complex pulmonary disease in the early phase]
E Tanaka1, M Taniguchi, Y Yuba
1Department of Infection & Inflammation, Kyoto University.
Insights
Early pulmonary Mycobacterium avium complex infection was diagnosed in a patient presenting with hemoptysis. Characteristic CT findings aided in the early identification of this infection, even without underlying conditions.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Pulmonary Mycobacterium avium complex (MAC) infections are increasingly recognized, often in patients with underlying lung diseases.
- Early diagnosis is crucial for effective management and improved patient outcomes.
- Computed tomography (CT) plays a vital role in the non-invasive evaluation of diffuse lung diseases.
Observation:
- A 51-year-old female presented with hemoptysis and radiographic infiltrates.
- Thoracic CT revealed nodular opacities and a small cavity in the right lung lobes.
- Bronchoscopy with biopsy identified epithelioid granulomas and Mycobacterium avium in bronchial washings.
Findings:
- The case suggests an early phase of pulmonary MAC infection in an immunocompetent individual.
- Histopathology confirmed granulomatous inflammation consistent with mycobacterial infection.
- Mycobacterium avium was successfully isolated, confirming the diagnosis.
Implications:
- Characteristic CT findings can facilitate early diagnosis of pulmonary MAC infection.
- This case highlights the potential for MAC infection in patients without apparent predisposing factors.
- Timely diagnosis through integrated imaging and microbiological analysis is essential for managing MAC pulmonary disease.
Abstract:
A 51-year-old female was admitted to our hospital due to hemoptysis. Chest radiography revealed infiltrations in the middle lobe. Computed tomography (CT) of the thorax showed clusters of small nodules associated with a small cavity in the middle lobe, ligula and lower lobe of the right lung. Bronchiectasis was not detected. Transbronchial lung biopsy specimen (B4a) showed epithelioid cell granulomas with giant cells, and Mycobacterium avium was isolated in 4-week cultures of bronchial washings. This could be a case of early phase of pulmonary Mycobacterium avium complex infection in a patient without a so-called underlying condition. CT findings were characteristic and useful for the early diagnosis of MAC infection.