Mycobacterium avium complex (MAC) infection

Case contributed by Dachani Kansan Naider


Pacific Islander with chronic cough. Recent chest X-ray reported to have pulmonary nodules. TB was ruled out on microbiology.

Patient Data

Age: 45 years
Gender: Male

HRCT of chest

  • Patchy saccular bronchiectasis identified in the anterior and lingual segment of the left upper lobe
  • Similar appearance also demonstrated in the anterior segment of the right upper lobe
  • The right middle lobe is completely obliterated, replaced by saccular bronchiectasis
  • Some of these bronchiectatic changes contain secretions
  • Apart from the bronchiectasis as mentioned earlier, there is no other feature of pulmonary fibrosis such as honeycombing

Case Discussion

The distribution of saccular bronchiectasis with normal appearance of the remaining unaffected lungs on this CT scan strongly indicates a mycobacterium avium complex (MAC) infection without other suitable differential diagnoses. 

MAC infection is typically insidious, with chronic cough being the most common presentation.

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