A case of isolated pulmonary Mycobacterium avium complex infection in an immunocompetent host

A 48-year-old male presented with complaints of occasional dry cough and sneezing for the past 4 months and high-resolution computed tomography chest done showed tree in bud and patchy nodular opacities in the right upper lobe and right middle lobe. He underwent bronchoscopy and bronchoalveolar lavage Gene X-pert Mycobacterium Tuberculosis (MTB) was not detected, but cytology showed granulomas and hence he was started on empirical antituberculous therapy (Isoniazid, Rifampicin, Pyrazinamide and Ethambutol (HRZE) regimen). His acid-fast bacilli C/S reports during follow-up showed growth of Mycobacterium Avium complex (MAC). Drug sensitivity testing was done and then he was started on oral rifampicin, ethambutol, and azithromycin and this regimen was continued for the next 6 months.