Atypical mycobacterial infection presenting as a tracheal mass in an immunocompetent child: Case report

Cervical lymphadenitis is the most common presentation of atypical mycobacterium infections in immunocompetent pediatric patients. Regional or extensive spread, such as intrathoracic NTM infections or systemic disease, is more commonly encountered in immunocompromised patients. A previously healthy 21-month-old female presented with a one-month history of cough, wheezing, and increased work of breathing. Her upper respiratory symptoms persisted, and imaging revealed an endotracheal mass. Bronchoscopy confirmed a mass obstructing approximately 90% of the tracheal lumen. Biopsy of the mass confirmed Mycobacterium avium complex infection. The patient was managed with prolonged antibiotic therapy and surgical debulking, resulting in clinical resolution of her respiratory symptoms. Due to the rarity of this patient's disease presentation, no treatment guidelines currently exist for this particular clinical manifestation. This case report highlights the successful use of combined surgical and medical therapies leading to symptom improvement and disease remission.