Acquired tracheoesophageal fistula in disseminated Mycobacterium avium complex associated with anti-interferon-gamma autoantibodies

alkiviadis.1961 shared this article with you from Inoreader Acquired tracheoesophageal fistula in disseminated Mycobacterium avium complex associated with anti-interferon-gamma autoantibodies Via BMJ Case Reports Last 6 Issues We describe a case of a 30-year-old previously healthy woman who presented to our hospital with a 2-month history of fevers, tender lymphadenopathy, dysphagia, globus sensation and occasional haematemesis. Further evaluation revealed cervicothoracic adenopathy and a subcarinal mass with oesophageal involvement. Imaging showed a transesophageal fistula at the level of the carina with contrast extravasation to the left main bronchus. Our patient was diagnosed with disseminat ed Mycobacterium avium complex (MAC) based on acid-fast bacillus noted on sputum cultures and nodal biopsies. Further investigation revealed anti-interferon-gamma autoantibodies as a possible predisposing factor for the disseminated MAC infection. This case demonstrates the importance of a broad differential diagnoses in a patient presenting with unexplained cervicothoracic lymphadenopathy, fever and dysphagia. Although acquired tracheoesophageal fistulae are uncommon, it should be considered in the clinical setting of globus sensation, haemoptysis and dysphagia. Furthermore, our case highlights a rare predisposition to disseminated Mycobacterium infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.