A tale of two images: From mycobacterium avium complex-lung disease (MAC-LD) to mycobacterium avium complex-pleural disease.

Autor:	Varkey MR; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care & Allergy Immunology, USA., Kohal TM; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care & Allergy Immunology, USA., Barua A; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care & Allergy Immunology, USA., Lapinel NC; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care & Allergy Immunology, USA., Ali J; Louisiana State University Health Sciences Center, Section of Pulmonary/Critical Care & Allergy Immunology, USA.
Jazyk:	angličtina
Zdroj:	Respiratory medicine case reports [Respir Med Case Rep] 2021 Apr 13; Vol. 33, pp. 101410. Date of Electronic Publication: 2021 Apr 13 (Print Publication: 2021).
DOI:	10.1016/j.rmcr.2021.101410
Abstrakt:	The typical radiographic presentation for Mycobacterium avium complex lung disease (MAC-LD) is either nodular bronchiectasis or cavitary lung disease. The former is seen most commonly in middle-aged or elderly Caucasian females with the characteristic asthenic phenotype, and the latter in middle-aged male smokers with COPD. We present the case of a young, otherwise healthy woman, with no significant risk factors, who was incidentally found to have MAC-LD with associated bronchiectasis. The patient's treatment and clinical course over a period of 5 years was marred by erratic follow up, intermittent treatment and poor adherence to guideline-based antibiotic therapy. Over this period of time, the patient developed significant worsening of her MAC-LD, macrolide resistance and failure to thrive. Upon presentation 5 years after her initial diagnosis, she had developed MAC-Pleural Disease with an empyema and broncho-pleural fistula. This case illustrates the progression of MAC-LD from nodular bronchiectasis to cavitary disease and pleural involvement leading to clinical deterioration. It highlights challenges related to short and long term management of macrolide resistant MAC-LD and the importance and need for surgical intervention and drainage procedures in patient with MAC-Pleural Disease. Competing Interests: None. (© 2021 The Author(s).)
Databáze:	MEDLINE
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