Case Report

A Case of Mycobacterium avium Complex Pulmonary Disease in an Immunocompetent Host

Authors: Zaka U. Khan, MD, Juan Guardiola, MD, Gary Salzman, MD

Abstract

Mycobacterium avium complex is the most common of nontuberculous mycobacterium capable of causing disease in humans. The manifestations can vary from asymptomatic exposure to hypersensitivity pneumonitis to advanced fibrocavitary disease. We describe the case of a 37-year-old male with advanced cavitary disease from Mycobacterium aviumcomplex. The patient had no previous history of pulmonary disease, but did have a history of snorting crushed Lortab (hydrocodone/acetaminophen) tablets and we postulate that possible injury to the lung from talc or other chemicals in the tablets may have predisposed him to develop Mycobacterium avium pulmonary disease.


Key Points


* Mycobacterium avium complex (MAC) is the most common of nontuberculous mycobacteria that is capable of causing disease in humans.


* In immunocompetent patients, two patterns of pulmonary MAC disease (MAC-PD) are described as “primary” and “secondary.”


* The symptoms are variable and not specific.


* The diagnosis of pulmonary disease due to nontuberculous mycobacteria is based on a combination of clinical, microbiologic and radiological criteria published by the American Thoracic Society


* Snorting crushed Lortab pills may have predisposed our patient to the development of M avium complex pulmonary disease.

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