Isolated EndobronchialMycobacterium aviumDisease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review

Abstract

The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant iterature.

Endobronchial Lesions from Disseminated <i>Mycobacterium avium</i> Infection in a Patient with Anti-interferon-gamma Autoantibodies

“…Four of the cases, including the present patient, were diagnosed with disseminated MAC infections (9,10,13), and only two were positive for anti-IFN-γ autoantibodies (13). The endobronchial findings of these patients indicated polypoid or ulcerated lesions, similar to those seen with endobronchial tuberculosis (21,22), and in some cases, polypoid masses caused endobronchial obstruction (8)(9)(10)(11)(12)16). In addition, the histological findings of these endobronchial lesions revealed granulomatous inflammation in most cases, for which tissue cultures identified NTM.…”

“…Endobronchial lesions caused by NTM infections are uncommon in both immunocompetent and immunocompromised hosts. To date, only 11 cases of endobronchial lesions from NTM infections in adult non-HIV patients have been reported, as summarized in Table (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Among these cases, MAC was the most common mycobacterium found (9-11, 13-16, 18), followed by M. kansasii (8,12) and M. abscessus (17).…”

“…Endobronchial lesions from NTM are uncommon, regardless of the host's immune status (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). These lesions typically present as polypoid or ulcerative lesions and can lead to endobronchial obstruction (8)(9)(10)(11)(12)16). There have been only a few reports of endobronchial lesions due to NTM infections in non-HIV adult patients, including cases with disseminated NTM infections associated with anti-IFN-γ autoantibodies.…”

Invasive Tracheobronchial Aspergillosis with Bronchial Ulcers Complicated by Nontuberculous Mycobacterial Disease

“…We considered ANCA-related vasculitis, NTM disease and adverse effects of BAE as potential causes of the bronchial ulcers in addition to ITBA. We rejected ANCA-related vasculitis and NTM disease because the patient had no abnormalities in any part of the body except the bronchus and there was no epithelioid granuloma in the biopsy specimen of the bronchial ulcers (15,16). BAE is a treatment of he-moptysis that may rarely cause bronchial necrosis, stenosis or ischemia (17)(18)(19).…”

Infections causing central airway obstruction: role of bronchoscopy in diagnosis and management

“…Most endobronchial NTM infections have been reported to be caused by MAC and Mycobacterium kansasii. In cases of MAC, the bronchoscopic appearance varies and can present as polypoid lesions (34,(95)(96)(97)(98)(99)(100), endobronchial masses, multiple nodular lesions (101), ulcerative lesions with bronchial strictures (102,103), caseating endobronchial lesions (104) and as white-yellow irregular mucosal lesions. Mycobacterium kansasii has been reported as endobronchial masses, sessile polypoid lesions, mass with ulcerations and nodular lesions (31,(105)(106)(107)(108)(109).…”