{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T02:36:19Z","timestamp":1793500579009,"version":"4.5.0"},"reference-count":6,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,8,16]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>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 disseminated <jats:italic>Mycobacterium avium<\/jats:italic> 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 <jats:italic>Mycobacterium<\/jats:italic> infection.<\/jats:p>","DOI":"10.1136\/bcr-2020-235661","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T03:16:09Z","timestamp":1604459769000},"page":"e235661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Acquired tracheoesophageal fistula in disseminated <i>Mycobacterium avium<\/i> complex associated with anti-interferon-gamma autoantibodies"],"prefix":"10.1136","volume":"13","author":[{"given":"Ibrahim","family":"Yaghnam","sequence":"first","affiliation":[{"name":"Internal Medicine, Penn State Health Milton S. Hershey Medical Center Department of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashma","family":"Golamari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Clarke","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology, Department of Medicine, Pennsylvania State University Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,11,3]]},"reference":[{"key":"2025082802445297000_13.11.e235661.1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2003.140"},{"key":"2025082802445297000_13.11.e235661.2","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.tgie.2008.07.002","article-title":"Endoscopic approach to tracheoesophageal fistulas in adults","volume":"10","author":"Ross","year":"2008","journal-title":"Tech Gastrointest Endosc"},{"key":"2025082802445297000_13.11.e235661.3","first-page":"S389","article-title":"The treatment strategy for tracheoesophageal fistula","volume":"7","author":"Ke","year":"2015","journal-title":"J Thorac Dis"},{"key":"2025082802445297000_13.11.e235661.4","first-page":"24","article-title":"Endoscopic management of tracheoesophageal fistulas","volume":"32","author":"Ramai","year":"2019","journal-title":"Ann Gastroenterol"},{"key":"2025082802445297000_13.11.e235661.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.04.026"},{"key":"2025082802445297000_13.11.e235661.6","doi-asserted-by":"crossref","unstructured":"Yeh Y-K , Ding J-Y , Ku C-L , et al . Disseminated Mycobacterium avium complex infection mimicking malignancy in a patient with anti-IFN-\u03b3 autoantibodies: a case report. BMC Infect Dis 2019;19.doi:10.1186\/s12879-019-4564-4","DOI":"10.1186\/s12879-019-4564-4"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-235661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:45:07Z","timestamp":1756374307000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-235661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":6,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,3]]},"published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1136\/bcr-2020-235661"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-235661","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}