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The Expanding Spectrum of Mycobacterium avium Complex-Associated Pulmonary Disease*

E. Andrew Waller, MD; Archana Roy, MD; Lisa Brumble, MD; Andras Khoor, MD; Margaret M. Johnson, MD, FCCP; Jeffrey L. Garland, MD, FCCP
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*From the Divisions of Pulmonary Medicine (Drs. Waller, Johnson, and Garland) and Infectious Disease (Dr. Brumble), and the Departments of Hospital Medicine (Dr. Roy) and Pathology (Dr. Khoor), Mayo Clinic, Jacksonville, FL.

Correspondence to: E. Andrew Waller, MD, Mayo Clinic, Jacksonville, Department of Pulmonary Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224; e-mail: waller.ernest@mayo.edu



Chest. 2006;130(4):1234-1241. doi:10.1378/chest.130.4.1234
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Nontuberculous mycobacteria (NTM) are increasingly recognized as important pulmonary pathogens. Mycobacterium avium intracellulare complex (MAC) causes most lung infections due to NTM. Patients with preexisting lung disease or immunodeficiency are at greatest risk for developing MAC infection. The majority of MAC pulmonary cases, however, occur in immunocompetent elderly women in association with nodular infiltrates and bronchiectasis. More recently, pulmonary disease has also been described in immunocompetent patients after exposure to MAC-contaminated hot tubs. We describe a case of aggressive MAC lung disease in a young immunocompetent female patient without preexisting lung disease whose clinical and pathologic characteristics do not fit into any of these categories and may represent a unique manifestation of MAC lung disease.

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