Mycobacterium avium infection presenting as a mass of the right lung

Background: The diagnostic procedure of pulmonary masses in patients with A IDS is presented. Case Report: A 39-year-old patient with AIDS mas admitted to hospital be a knon-productive cough and radiologic evidence of mediastinal and right hila r masses suggestive of lymphoma associated with pneumonia of the right lowe r lobe. Bronchoscopy revealed a stenosis of the right lower lobe bronthus t hus with small endobronchial lesions. Biopsies showed granulomatous inflamm ation, microorganisms were detected. Chest pain with dyspnea developed and was relieved by evacuation of pus during mediastinoscopy. The diagnosis of Mycobacterium avium infection was established via culture of sputum and bro nchoalveolar lavage fluid and via mediastinoscopy. The patient was commence d on a 3-drug regimen with rifabutin, ethambutol and clarithromycin remaine d asymptomatic now for over 9 months Conclusion: Mycobacterium avium infection needs to be included in the diffe rential diagnosis of patients with AIDS presenting with mediastinal and hil ar When procedures such as bronchoscopy and chest CT-scans are non-diagnost ic, mediastinoscopy may become necessary in order to establish the diagnosi s.