Mycobacterium kansasaii and Mycobacterium scrofulaceum dual pulmonary infection in an immunocompetent male: first report from India

A 57-year-old farmer presented with chronic cough and recurrent hemoptysis, previously treated for sputum-positive pulmonary tuberculosis. Referred to us for evaluation of drug resistant tuberculosis as his sputum was persistently positive for acid-fast bacilli along with radiological worsening even after 6 months of antitubercular treatment. Bronchoalveolar lavage was performed and he was diagnosed with a rare mixed non-tuberculous mycobacteria (NTM) pulmonary infection despite no immune dysfunction. He was successfully treated with a multidrug regimen of rifampicin, isoniazid, ethambutol and clarithromycin.