Extensive Mediastinal Lymphadenopathy in an Adult Immunocompetent Woman Caused by Mycobacterium avium Complex

Greinert, U.; Rüsch-Gerdes, Sabine; Vollmer, Ekkehard; Schlaak, M

doi:10.1378/chest.116.6.1814

Cited by 8 publications

(3 citation statements)

References 4 publications

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“…There is a case with thoracic presentation and imaging findings similar to the children reported here in an immunocompetent 29-yearold woman. 17 The presentations in the majority of reported cases are similar to those in our series, with cough and wheezing predominating; in the review of 43 patients, only 23 had associated fever. 12 The majority of reported patients have been treated with prolonged combination antimycobacterial agents after biopsy diagnosis with or without surgical resection; some have been treated with limited antibiotics after surgical resection.…”

Section: Pediatric Pulmonologysupporting

confidence: 81%

“…The patients described here are similar to those in the literature with disease localized to endobronchial lesions or mediastinal lymph nodes. [9][10][11][12][13]17 Nolt et al reported 43 children with thoracic NTM disease; the median age was 24 months, the same age group we report here. 12 Although this appears to be the predominant age group, the disease may occur in older children or adults.…”

Section: Pediatric Pulmonologysupporting

confidence: 78%

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Intrathoracic nontuberculous mycobacterial infections in otherwise healthy children

Freeman

Olivier

Rubio

et al. 2009

Pediatric Pulmonology

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Background Nontuberculous mycobacterial (NTM) infection is typically associated with lymphadenitis in immune competent children, and disseminated disease in children with immune deficiencies. Isolated pulmonary NTM disease is seen in cystic fibrosis, and is increasingly recognized in immunocompetent elderly women, where it is associated with an increased incidence of cystic fibrosis transmembrane regulator (CFTR) mutations. Thoracic NTM infection has been reported rarely in otherwise healthy children. We aimed to determine whether otherwise healthy children with pulmonary NTM disease had immunologic abnormalities or CFTR mutations. Study Design Clinical presentations of five otherwise healthy children with pulmonary NTM were reviewed. Immunologic studies were performed including a complete blood cell count (CBC), flow cytometric lymphocyte phenotyping and IFN-gamma receptor expression, in vitro cytokine stimulation, and serum immunoglobulin levels. Mutational analysis was performed for CFTR. Results The children ranged in age from 12 months to 2.5 years at diagnosis. Four presented with new onset wheezing or stridor failing bronchodilator therapy. One child was asymptomatic. Endobronchial lesions and/or hilar lymph nodes causing bronchial obstruction were identified in all patients. Mycobacterium avium complex was cultured from four patients, and M. abscessus from one patient. All patients were successfully treated with anti-mycobacterial therapy with or without surgery. No definitive immunologic abnormalities were identified. No clinically significant mutations were found in CFTR. Conclusions Pulmonary NTM infection should be considered in otherwise healthy young children presenting with refractory stridor or wheezing with endobronchial lesions or hilar lymphadenopathy. It does not appear to be associated with recognized underlying immune deficiency or CFTR mutations.

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Section: Pediatric Pulmonologysupporting

confidence: 81%

Section: Pediatric Pulmonologysupporting

confidence: 78%

Intrathoracic nontuberculous mycobacterial infections in otherwise healthy children

Freeman

Olivier

Rubio

et al. 2009

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…We report a rare disseminated MAC case in an otherwise healthy, pregnant woman; there had been only sporadic case reports of disseminated MAC disease among immunocompetent adults [ 6 - 10 ]. Though the patient in this case was a HBV carrier, there was no evidence of liver cirrhosis on physical examination and abdominal sonogram.…”

Section: Discussionmentioning

confidence: 99%