A case of Mycobacterium avium-associated hypersensitivity pneumonitis

Antigen avoidance combined with azithromycin and ethambutol led to sustained clinical and radiological improvement and successful steroid tapering without restrictive ventilatory impairment. This case underscores the importance of routinely sending mycobacterial cultures from bronchoalveolar lavage in suspected HP and of carefully reassessing environmental exposures, even in outdoor settings, as identifying NTM as the causative antigen can substantially modify management.