title: Endobronchial avium mycobacteria infection in an immunocompetent child.
abstract: A 12-month-old boy, with no medical history, was admitted for dyspnoea with no cough or fever. Chest auscultation revealed an expiratory wheezing with decreased right-sided breath sounds. Chest imaging revealed subcarinal adenopathy and a nodule in the right principal bronchus (RB). Bronchoscopy showed a major obstruction of the RB by a granuloma, and a smaller granuloma in the left principal bronchus. The granulation tissue was removed by laser section. Histological examination revealed a necrotising granulomatous inflammation, culture showed a Mycobacterium avium complex (MAC). Tests to rule out tuberculosis and immunodeficiency were negative. The diagnosis of an MAC endobronchial granuloma was ascertained and a multidrug therapy associating clarithromycin, rifampin and ethambutol was started. The clinical outcome was good after 3 months of treatment and the bronchoscopy normalised after 1 year. Although rare, the frequency of MAC respiratory infections in immunocompetent children can increase. Reporting these cases should help to optimise diagnosis and treatment.
authors.affiliation: Pediatric Pulmonology-INSERM UMR S-938, AP-HP Hôpital Armand Trousseau, Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Perisson
authors.forename: Nadia
authors.initials: N
authors.lastname: Nathan
authors.forename: Briac
authors.initials: B
authors.lastname: Thierry
authors.forename: Harriet
authors.initials: H
authors.lastname: Corvol
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001996:Bronchopneumonia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D053685:Laser Therapy; D008297:Male; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents