Esophageal hyperkeratosis in a teenager with asthma and chronic cough complicated by nontuberculous mycobacteria pulmonary infection

We present a case of a 16-year-old boy with asthma referred to pediatric gastroenterology for nausea and chronic cough. Esophagogastroduodenoscopy and bronchoscopy revealed parakeratosis/hyperkeratosis in the esophagus and nontuberculous mycobacteria pulmonary infection, respectively. Presumed reflux as a unifying cause for his symptoms was confirmed with intra-esophageal pH monitoring, and he was successfully treated with a proton pump inhibitor and a four-drug antimicrobial regimen.