Abstract
We report a case of a 39-year-old HIV positive transgender female with isolated manifestations of pulmonary Mycobacterium avium complex (MAC) infection. Although MAC infection is common in immunocompromised patients, the classical presentation is extra-pulmonary. Pulmonary MAC infection is extremely rare. The majority of cases involve patients with underlying structural lung disease. There are no case reports of isolated pulmonary MAC in HIV/AIDS patients without any structural lung disease in the last 17 years. Also, we have not found any cases of newly diagnosed HIV/AIDS patients with pulmonary MAC being the initial presentation.
Highlights
Mycobacterium avium complex (MAC) is a free-living bacterium found in water, soil, and dust
Treatment includes a combination of antimicrobial therapy. This case reported describes an HIV/AIDS patient who was found to have isolated pulmonary disease caused by Mycobacterium avium complex
On subsequent follow-up in infectious disease clinic, she showed marked improvement of her symptoms. This is a young patient who came with no significant medical history of structural lung disease who presented with persistent cough of four months duration that did not respond to multiple trials of antibiotics
Summary
Mycobacterium avium complex (MAC) is a free-living bacterium found in water, soil, and dust. Treatment includes a combination of antimicrobial therapy This case reported describes an HIV/AIDS patient who was found to have isolated pulmonary disease caused by Mycobacterium avium complex. The patient was being treated for community-acquired pneumonia with ceftriaxone and azithromycin. All of her tests for pulmonary tuberculosis were negative and she was discharged home after mild symptomatic improvement. On subsequent visit to the infectious disease clinic, she continued to have persistent cough with other constitutional symptoms. Physician revealed that her respiratory culture was positive of MAC identified by DNA probe. On subsequent follow-up in infectious disease clinic, she showed marked improvement of her symptoms
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