Presentation
Chronic cough and sputum.
Patient Data
There are lung parenchymal clusters of small nodules, branching opacities, and small airway dilatation. The changes have a predilection for the middle lobe and lingula, supporting the diagnosis of MAC infection. Pleural spaces are clear.
No mediastinal or hilar lymphadenopathy. Moderate calcification of the coronary arteries, in particular the LAD. No pericardial effusion.
Conclusion: Findings are compatible with pulmonary MAC.
Bronchial lavage sample: Acid-fast bacilli detected
Mycobacterial culture: Mycobacterium avium Complex ISOLATED
Case Discussion
Pulmonary changes are supportive of MAC. Bronchiectasis with associated centrilobular nodules is the dominant feature, which, unlike pulmonary tuberculosis, does not have a predilection for the upper lobes.
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