| 1 | A case of Mycobacterium avium complex infection in an immunocompetent man presenting with pericarditis and an HRCT pattern of lymphangitis3 | 2008 | A man in his early 50s presented with low-grade fever, malaise, dry cough and chest pain. Transthoracic echocardiography confirmed the presence of a mild pericardial effusion. HRCT showed evidence of pulmonary nodules in a lymphangitic pattern. The patient was immunocompetent. He was treated with clarithromycin and rifabutin for 10 months.
| This patient is a middle-aged man with evidence of primarily pulmonary MAC with a mild pericarditis. Our patient was a young woman with a large pericardial effusion with primarily pericardial MAC. Unlike this patient, she had no evidence of disseminated disease and so was treated with NSAID and drainage. She did not require antimicrobials.
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| 2 | A case study of Mycobacterium avium complex infection presenting with acute pericarditis6 | 2014 | A man in his early 70s presented with dyspnoea and pleuritic chest pain. A retired plumber, non-smoker and no history of lung disease On presentation was febrile, tachycardic and normotensive. Found to have moderate pericardial effusion up to 15 mm on CT and on echocardiogram Echo showed evidence of tamponade physiology, and he had 400 mL of pericardial fluid drained, which grew MAC. He was immunocompetent. He declined anti-mycobacterial and was discharged with NSAIDs. Poor compliance with NSAIDs led to recurrence. The patient resumed NSAIDs and was treated with an extended course and fully resolved without anti-mycobacterial.
| This patient is an elderly man. Non-smoker and no history of pulmonary disease like our patient. Has a moderate effusion with cardiac tamponade compared with our case where effusion was large with tamponade. Like our case, the condition was resolved with surgical intervention and NSAIDs without anti-mycobacterial.
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| 3 | Mycobacterium Avium Complex-Related Pericardial Effusion in an Immunocompetent Patient11 | 2017 | A woman in her late 50s with a 25 pack-year active smoking history presented with a cough productive of white sputum associated with 12-pound weight loss and decreased exercise tolerance. CT showed evidence of bronchiectasis, numerous pulmonary nodules, a large pericardial effusion with pericardial enhancement and a 2 cm hypodense hepatic lesion. The echocardiogram did not reveal any signs consistent with tamponade physiology. CT-guided biopsy of her pulmonary nodules revealed non-necrotising granulomas. Serial sputum samples showed MAC. Autoimmune workup and HIV testing were negative. The patient declined pericardiocentesis, and was treated with rifampin, azithromycin and ethambutol. After 3 months, her symptoms resolved, and pericardial effusion decreased in size on repeat serial echocardiogram.
| This patient is also female; however, she has an extensive smoking history and has primarily pulmonary MAC. She also has a large effusion like our patient. Unlike our patient, she did not have cardiac tamponade, declined pericardiocentesis and was treated with anti-mycobacterial.
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| 4 | A hemodialysis patient with Mycobacterium avium complex pericarditis in which remarkable presepsin elevation was not accompanied by procalcitonin elevation7 | 2020 | A man in his late 60s with a history of ESRD on HD and diabetes presented with cough and dyspnoea. He was found to have cardiac tamponade. 900 mL of pericardial fluid was drained, which grew MAC. He was HIV negative, had no evidence of malignancy or systemic immune dysfunction. He was not treated with anti-mycobacterial agents, and his condition resolved.
| This patient was a male with a history of DM and ESRD on HD. Our patient did not have such significant comorbidities. The management and outcomes were similar in that the patient was treated with surgical drainage and resolved without anti-mycobacterial agents. Pericardial effusion was also large with cardiac tamponade.
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