Bronchoscopic diagnosis of Mycobacterium avium complex in kartagener syndrome

We report a case of a patient with Kartagener syndrome and bronchiectasis who presented with prolonged course of unremitting fever and respiratory tract infection. Gram stain of multiple samples of expectorated sputa showed gram-negative rods and gram-positive cocci. Despite treatment with broad-spectrum oral and later intravenous antibiotics, her condition did not improve. However, bronchoscopic collection of bronchoalveolar lavage fluid showed abundance of Mycobacterium avium complex (MAC), which was not previously detected on the sputa. In patients with ciliary dysfunction, including patients with Kartagener syndrome, yield of bronchoscopic bronchoalveolar lavage for diagnosis of mycobacteria is superior to expectorated sputa.