Endobronchial Mycobacterium Avium-Intracellulare Infection in Lung Transplant Recipients.

Shamitha Hejmadi, Rutvik Raval, Atul C Mehta
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Abstract

Endobronchial Mycobacterium avium-intracellulare (MAI) infection has been described in immunocompromised patients but is rare among transplant recipients. We present a case of a 48-year-old male with a history of coal miners' pneumoconiosis who underwent bilateral lung transplantation. Ten months post-transplant, despite normal spirometry and absence of respiratory symptoms, routine surveillance bronchoscopy revealed multiple endobronchial polypoid lesions. Biopsy demonstrated non-necrotizing granulomatous inflammation, with cultures confirming MAI infection. This case underscores the importance of maintaining a high index of suspicion for atypical infections like MAI in lung transplant recipients, even in the absence of overt clinical symptoms. This case's unique presentation adds to our understanding of potential post-transplant complications and may help clinicians recognize similar presentations in the future.

支气管内分枝杆菌(MAI)感染在免疫力低下的患者中已有描述,但在移植受者中却很少见。我们报告了一例 48 岁男性患者的病例,该患者有煤矿工人尘肺病史,接受了双侧肺移植手术。移植后 10 个月,尽管肺活量正常且无呼吸道症状,但常规监测支气管镜检查发现多发支气管内息肉样病变。活检显示为非坏死性肉芽肿性炎症,培养证实为 MAI 感染。本病例强调,即使没有明显的临床症状,也要高度怀疑肺移植受者感染 MAI 等非典型感染。本病例的独特表现增加了我们对移植后潜在并发症的了解,可能有助于临床医生今后识别类似的表现。
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