{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:27:55Z","timestamp":1768004875024,"version":"3.49.0"},"reference-count":24,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,8,7]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>Pulmonary sequestration is a rare congenital condition. It is a dysplastic lung tissue with a separate systemic blood supply and without a bronchial tree connection. The emergence of a superimposed infection can lead to its diagnosis, such as <jats:italic>Staphylococcus aureus, Pseudomonas aeruginosa, Nocardia asteroids and Aspergillus sp<\/jats:italic>. pneumonia. Mycobacterium avium complex (MAC) superimposed disease is exceedingly rare. We report a case of a man in his third decade without known medical disorders presenting with a persistent cough. After an extensive microbiological workup, an MAC infection was diagnosed. An elevated carbohydrate antigen 19-9 (CA 19-9) was also noted. He was treated with antimycobacterial therapy and lobectomy resulting in clinical improvement and CA19-9 normalisation. This case illustrates the value of comprehensive microbiological investigations in patients with chronic respiratory symptoms and imaging findings that are not typical of bacterial pneumonia. Clinical studies remain needed to investigate the utility of CA 19-9 in a scoring system to guide MAC therapy.<\/jats:p>","DOI":"10.1136\/bcr-2023-255346","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T20:36:34Z","timestamp":1694550994000},"page":"e255346","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Unravelling the mystery of a rare infection: a challenging case of pulmonary sequestration with Mycobacterium avium complex and the importance of a thorough microbiological investigation"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9225-278X","authenticated-orcid":false,"given":"Abdallah","family":"Mughrabi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, St. Elizabeth's Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Fennelly","sequence":"additional","affiliation":[{"name":"Internal Medicine, FMC Devens, Ayer, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicitas","family":"Fandreyer","sequence":"additional","affiliation":[{"name":"Internal Medicine, FMC Devens, Ayer, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Fleisher","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, St. Elizabeth's Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachussets, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"2025082801483895000_16.9.e255346.1","doi-asserted-by":"publisher","DOI":"10.1067\/j.cpradiol.2014.01.005"},{"key":"2025082801483895000_16.9.e255346.2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.clinimag.2020.11.040","article-title":"Pulmonary sequestration: what the Radiologist should know","volume":"73","author":"Gabelloni","year":"2021","journal-title":"Clin Imaging"},{"key":"2025082801483895000_16.9.e255346.3","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu397"},{"key":"2025082801483895000_16.9.e255346.4","doi-asserted-by":"crossref","DOI":"10.1136\/thx.2004.037705","article-title":"Infected pulmonary sequestration caused by Mycobacterium Kansasii","volume":"60","author":"Lin","year":"2005","journal-title":"Thorax"},{"key":"2025082801483895000_16.9.e255346.5","doi-asserted-by":"crossref","first-page":"762","DOI":"10.21037\/jtd.2017.03.107","article-title":"Clinical presentation and characteristics of 25 adult cases of pulmonary sequestration","volume":"9","author":"Polaczek","year":"2017","journal-title":"J Thorac Dis"},{"key":"2025082801483895000_16.9.e255346.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1125"},{"key":"2025082801483895000_16.9.e255346.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2010.06.008"},{"key":"2025082801483895000_16.9.e255346.8","unstructured":"Strnad L , Winthrop K . Mycobacterium Avium complex. In: Principles and Practice of Infectious Diseases. Elsevier, 2020: 3035\u201346."},{"key":"2025082801483895000_16.9.e255346.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2004.10.007"},{"key":"2025082801483895000_16.9.e255346.10","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.17.3.9153708"},{"key":"2025082801483895000_16.9.e255346.11","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.cr.11.01835"},{"key":"2025082801483895000_16.9.e255346.12","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-59121-0"},{"key":"2025082801483895000_16.9.e255346.13","doi-asserted-by":"crossref","unstructured":"Murthy R , Kernstine K , Burkhart H , et al . Sabiston and Spencer surgery of the chest. In: Sabiston and Spencer Surgery of the Chest, Ninth Edit. Elsevier, 2016: 151\u201378.","DOI":"10.1016\/B978-0-323-24126-7.00009-0"},{"key":"2025082801483895000_16.9.e255346.14","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000011714","article-title":"Pulmonary sequestration associated with increased serum tumor markers and elevated standard uptake value level in PET\/CT: A case report and literature review","volume":"97","author":"Li","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"2025082801483895000_16.9.e255346.15","doi-asserted-by":"crossref","DOI":"10.1186\/s13019-021-01688-4","article-title":"Elevated tumor markers in a benign lung disease","volume":"16","author":"Chen","year":"2021","journal-title":"J Cardiothorac Surg"},{"key":"2025082801483895000_16.9.e255346.16","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.bjid.2015.09.005","article-title":"Elevated serum CA 19-9 levels in patients with pulmonary Nontuberculous Mycobacterial disease","volume":"20","author":"Hong","year":"2016","journal-title":"Braz J Infect Dis"},{"key":"2025082801483895000_16.9.e255346.17","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s12890-018-0663-z","article-title":"Pulmonary sequestration in adults: a retrospective review of Resected and Unresected cases","volume":"18","author":"Alsumrain","year":"2018","journal-title":"BMC Pulm Med"},{"key":"2025082801483895000_16.9.e255346.18","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.chest.2021.10.003","article-title":"Nontuberculous Mycobacterial pulmonary disease: clinical epidemiologic features, risk factors, and diagnosis: the Nontuberculous Mycobacterial series","volume":"161","author":"Kumar","year":"2022","journal-title":"Chest"},{"key":"2025082801483895000_16.9.e255346.19","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezu407","article-title":"Bilateral pulmonary sequestration with mixed infection caused by two types of non-tuberculous mycobacteria in pregnancy","volume":"47","author":"Cho","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025082801483895000_16.9.e255346.20","doi-asserted-by":"publisher","DOI":"10.1016\/S1995-7645(12)60172-2"},{"key":"2025082801483895000_16.9.e255346.21","first-page":"277","article-title":"Two cases of Intralobar pulmonary sequestration associated with Nontuberculous Mycobacterial infection in a young patient","volume":"42","author":"Miyazaki","year":"2004","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"2025082801483895000_16.9.e255346.22","doi-asserted-by":"crossref","first-page":"990","DOI":"10.2169\/internalmedicine.41.990","article-title":"Pulmonary sequestration associated by Mycobacterium Intracellulare infection","volume":"41","author":"Shiota","year":"2002","journal-title":"Intern Med"},{"key":"2025082801483895000_16.9.e255346.23","first-page":"399","article-title":"A case of pulmonary sequestration with atypical Mycobacterial infection","volume":"36","author":"Sekine","year":"1998","journal-title":"Nihon Kokyuki Gakkai Zasshi"},{"key":"2025082801483895000_16.9.e255346.24","doi-asserted-by":"publisher","DOI":"10.1378\/chest.68.4.594"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:48:50Z","timestamp":1756370930000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,12]]},"published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1136\/bcr-2023-255346"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255346","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}