An Atypical Etiology for Granulomatous Mediastinal Lymphadenopathy in an Immunocompetent Adult Male

Abstract

Abstract Nontuberculous mycobacteria (NTM) are widely distributed microorganisms that have the potential to cause severe illness in humans, especially those with compromised immune systems. In adults, the disease mainly manifests as chronic pulmonary disease. Few case reports are available on lymphadenopathy caused by nontubercular mycobacterium in children, primarily affecting the cervical lymph nodes. However, it is exceptionally rare for an immunocompetent adult to develop mediastinal lymphadenopathy due to NTM infection. We present a case of posttubercular fibrocavitary lung disease with mediastinal adenopathy in an immunocompetent male. The initial clinical suspicion was the reactivation of tuberculosis. However, the cultures from the mediastinal node aspirate obtained by Endo Bronchial Ultra Sound guided Trans Bronchial Needle Aspiration (EBUS-TBNA) and the bronchoalveolar lavage showed growth of nontubercular mycobacterium. Our literature search only revealed a case report discussing mediastinal lymphadenopathy associated with NTM in an immunocompetent individual.