Endotracheal involvement from atypical mycobacterium causing respiratory difficulty: Case report and literature review

Abstract

Atypical mycobacterium infections often present as cervicofacial lymphadenitis in pediatric patients. Endotracheal involvement, however, is rare, and has not been previously described with imaging and photographs.

An infant with natural killer T-cell deficiency was admitted with cough, rhinorrhea, and cervical lymphadenopathy. Laryngotracheobronchitis-type symptoms persisted and imaging revealed an intraluminal abnormality of the trachea. Endoscopy confirmed a mediastinal lymph node with intrusion into the tracheal lumen. Intraluminal biopsy was deferred due to concerns of airway loss. Biopsy of the associated cervical lymph node confirmed Mycobacterium avium-intracellulare infection. The patient was managed with antibiotics and steroids with clinical resolution of his respiratory symptoms.