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Mycobacterium avium complex pulmonary disease — SCE Respiratory MCQ

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HardRespiratory InfectionsMycobacterium avium complex pulmonary diseaseSCE Respiratory

A 69-year-old woman with bronchiectasis has weight loss, daily sputum and CT showing nodular bronchiectatic disease with tree-in-bud change. Three sputum cultures over 4 months grow Mycobacterium avium complex and smear is intermittently positive. What is the most likely diagnosis?

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Correct answer: E — Mycobacterium avium complex pulmonary disease

Clinical symptoms, compatible CT findings and repeated positive cultures meet criteria for MAC pulmonary disease rather than an incidental isolate. Latent TB has no active radiological or sputum culture disease, and invasive aspergillosis requires a different host and microbiological pattern. Acute bacterial pneumonia is less consistent with the chronic nodular-bronchiectatic course.

Reference: BTS NTM-PD Guideline; BTS Bronchiectasis Guideline