Marked IgE elevation and eosinophilia in a COPD patient ultimately diagnosed with mycobacterium intracellulare pulmonary disease.
Deniz Eyice Karabacak
✦ AI-curated · Sources linked
Case in brief
A 65-year-old man with COPD presented with persistent eosinophilia and significantly elevated total IgE levels. Initial evaluations for allergic diseases were negative. Imaging revealed severe emphysema with patchy consolidations, and subsequent sputum cultures confirmed Mycobacterium intracellulare infection. This case underscores the importance of considering non-tuberculous mycobacterial infections in patients with unexplained eosinophilia.
What made this case unusual
The case is notable for the presentation of Mycobacterium intracellulare infection with marked eosinophilia and elevated IgE, which typically suggest allergic or parasitic conditions.
Diagnostic / clinical pearl
Clinicians should consider non-tuberculous mycobacterial infections in the differential diagnosis of unexplained eosinophilia and elevated IgE, especially in patients with underlying lung disease.
Why it matters
Recognizing this atypical presentation can lead to timely diagnosis and management of Mycobacterium intracellulare pulmonary disease, which may otherwise be overlooked.