Mycobacterium Avium Complex Presenting as a Lung Mass, Broncho-pleural Fistula and Empyema in an....

In patients with chronic systemic lung pathology such as emphysema, chronic bronchitis, and bronchiectasis, Mycobacterium avium complex (MAC) causes subacute or chronic nodular bronchiectasis, cavitary or fibro-cavitary pneumonia. It is also known to cause pulmonary and extrapulmonary infections in patients with weakened cell-mediated immunity, such as transplant recipients and patients with AIDS (Acquired Immune Deficiency Syndrome). It's an uncommon occurrence, but empyema from MAC has been identified in immunocompromised patients. Despite comprehensive work-up, a patient with persistent left pleural effusion and a left lower lobe lung mass went undiagnosed for two years. He was diagnosed with MAC empyema later in his course after presenting with a massive effusion complicated by a bronchopleural fistula. This is the first case of MAC empyema that has presented as a chronic lung mass exacerbated by a bronchopleural fistula that we are aware of. The clinical, laboratory, and radiological features of MAC empyema are presented in this article, with a focus on a combined medical and surgical approach in the management of MAC empyema. We also offer a quick rundown of cases of pleurisy and empyema associated with MAC that have been published in the literature.

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