Pulmonary Mycobacterium avium complex infection

Case contributed by Bruno Di Muzio
Diagnosis almost certain


Chronic cough and sputum.

Patient Data

Age: 70 years
Gender: Male

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 MACBronchiectasis 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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