Abstract
Non-tuberculous mycobacteria, particularly Mycobacterium avium complex (MAC), have become significant causes of pulmonary infections, especially in immunocompromised individuals. MAC lung disease presents a diagnostic challenge due to its clinical overlap with other pulmonary conditions, including Mycobacterium tuberculosis infections. The need for microbiological confirmation and radiological evaluation complicates early diagnosis. New molecular diagnostic methods, such as PCR, have improved detection but are not universally accessible. Treatment for MAC lung disease typically involves a multidrug regimen including macrolides, rifamycins, and ethambutol. However, the disease often proves resistant to standard therapies, and treatment failure is common due to drug resistance, delayed diagnosis, and poor adherence. Recent research has highlighted the need for personalized treatment strategies and alternative therapies, such as intravenous antibiotics and host-directed treatments, to improve outcomes. The prognosis for MAC lung disease remains poor, especially in patients with preexisting lung conditions like bronchiectasis or rheumatoid arthritis, who are at increased risk of disseminated infection. This case report and review underscore the importance of early recognition and intervention, highlighting the role of a multidisciplinary approach in managing complex infections. Additionally, it emphasizes the need for continued research to identify more effective treatment options and improve patient outcomes in this growing patient population.