Synonym: Lady Windermere syndrome (a character from Oscar Wilde)
Common candidate:
(1) older adult
(2) female
(3) no evidence of chronic underlying lung disease
(4) immunocompetent
Clinical findings:
(1) chronic cough with sputum production
(2) dyspnea
(3) variable hemoptysis
(4) variable fatigue
(5) variable anorexia with weight loss
(6) variable fever
(7) variable night sweats
Pulmonary findings:
(1) MAC lesions are primarily in the right middle lobe and lingula of the left upper lobe.
(2) The chest X-ray shows reticular, fibrotic lesions without cavitation.
(3) Bronchiectasis is seen on high resolution CT or bronchoscopy.
Diagnosis may be delayed since symptoms may be mild and nonspecific. Identification of acid fast bacilli (AFB) on smear or culture is key to the diagnosis.
Other nontuberculous mycobacteria that can produce the same findings:
(1) M. abscessus
(2) M. kansasii
