title: The expanding spectrum of Mycobacterium avium complex-associated pulmonary disease.
abstract: Nontuberculous mycobacteria (NTM) are increasingly recognized as important pulmonary pathogens. Mycobacterium avium intracellulare complex (MAC) causes most lung infections due to NTM. Patients with preexisting lung disease or immunodeficiency are at greatest risk for developing MAC infection. The majority of MAC pulmonary cases, however, occur in immunocompetent elderly women in association with nodular infiltrates and bronchiectasis. More recently, pulmonary disease has also been described in immunocompetent patients after exposure to MAC-contaminated hot tubs. We describe a case of aggressive MAC lung disease in a young immunocompetent female patient without preexisting lung disease whose clinical and pathologic characteristics do not fit into any of these categories and may represent a unique manifestation of MAC lung disease.
authors.affiliation: Division of Pulmonary Medicine, Mayo Clinic, Jacksonville, Department of Pulmonary Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224, USA. waller.ernest@mayo.edu
authors.forename: E Andrew
authors.initials: EA
authors.lastname: Waller
authors.forename: Archana
authors.initials: A
authors.lastname: Roy
authors.forename: Lisa
authors.initials: L
authors.lastname: Brumble
authors.forename: Andras
authors.initials: A
authors.lastname: Khoor
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Johnson
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Garland
mesh_terms: D000328:Adult; D000583:Amikacin / Q000008:administration & dosage; D001706:Biopsy; D017291:Clarithromycin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000008:administration & dosage; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009336:Necrosis; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed
chemical_list: D000583:Amikacin; D004977:Ethambutol; D017291:Clarithromycin; D011241:Prednisone; D012293:Rifampin