title: Paranasal sinus infection due to atypical mycobacteria in two patients with AIDS.
abstract: Atypical mycobacteria, which are common opportunistic pathogens in patients with AIDS, have not been previously implicated in the pathogenesis of paranasal sinus infections; we describe two such patients. Clinical and radiographic evidence of bilateral maxillary and ethmoid sinusitis was observed for one patient; his infection proved resistant to therapy with conventional antimicrobials and decongestants. Endoscopic ethmoid sinus biopsy yielded a specimen containing acid-fast bacilli (AFB) that were later identified as Mycobacterium kansasii. Antimycobacterial therapy had not resulted in amelioration of the sinusitis > 2 months later, at which time he died of cerebral toxoplasmosis. The second patient presented with a tender right frontotemporal soft-tissue mass; a computed tomogram disclosed that it extended through the frontal bone to the frontal sinus. Inflamed tissue debrided from the sinus contained AFB; cultures first yielded M. kansasii and later Mycobacterium avium complex. Bacteremia due to both organisms was also demonstrated. Infection progressed despite therapy.
authors: Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
authors: M T
authors: MT
authors: Naguib
authors: J M
authors: JM
authors: Byers
authors: L N
authors: LN
authors: Slater
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*