{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:56:16Z","timestamp":1772999776103,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This article discusses whether a MAC\u2010infected patient with a positive Xpert MTB\/RIF test has a co\u2010infection with Mycobacterium tuberculosis (MTB). The patient presented with chronic, indolent pulmonary patchy shadows on imaging but lacked typical symptoms. The MTB antigen\u2010specific interferon\u2010gamma enzyme\u2010linked immunospot assay (T\u2010SPOT.TB) was negative. Bronchoalveolar lavage fluid (BALF) testing yielded conflicting results: Xpert MTB\/RIF assay detected trace levels of MTB DNA, whereas reverse dot blot hybridization confirmed the presence of Mycobacterium avium complex (MAC); in contrast, metagenomic next\u2010generation sequencing (mNGS) returned a negative result for all pathogens. Mycobacterial culture ultimately returned positive; however, the MPB64 assay\u2014employed for species identification\u2014yielded a negative result, indicating a probable nontuberculous mycobacterial (NTM) infection. Despite contradictory lab results, the patient's symptoms and culture findings favored MAC infection. However, MTB infection could not be definitively ruled out in this patient, so a treatment regimen combining anti\u2010tuberculosis and anti\u2010MAC medications (isoniazid, rifampicin, ethambutol, and azithromycin) was initiated, leading to significant radiographic improvement. The discordance between the positive Xpert MTB\/RIF result and other diagnostic evidence highlights important diagnostic challenges, underscoring the need for integrated clinical interpretation and providing actionable insights for clinicians.<\/jats:p>","DOI":"10.1002\/ccr3.71965","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:57:22Z","timestamp":1769839042000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Why a Mycobacterium Avium Infected Patient Showed a Positive Xpert\n                    <scp>MTB<\/scp>\n                    \/\n                    <scp>RIF<\/scp>\n                    Result?"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7670-9844","authenticated-orcid":false,"given":"Lei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine Zhongshan Hospital, Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Zhongshan Hospital, Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Zhongshan Hospital, Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongni","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Xiamen Branch, Zhongshan Hospital Fudan University  Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201804-236OC"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2022.10.013"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-055672"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09965-y"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00149212"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.24.0068"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-019-1243-3"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0020606"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01463-09"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-017-1044-x"},{"issue":"1","key":"e_1_2_14_12_1","article-title":"Xpert MTB\/RIF Assay for Pulmonary Tuberculosis and Rifampicin Resistance in Adults","volume":"2014","author":"Steingart K. 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