title: Mycobacterium kansasii infection presenting as cellulitis in a patient with systemic lupus erythematosus.
abstract: The prevalence of mycobacterial infection has increased in recent years, especially in patients immunocompromised due to autoimmune disease, malignancy and AIDS. Mycobacterium kansasii infection most commonly presents as tuberculosis-like pulmonary disease. We report the case of a 38-year-old woman with systemic lupus erythematosus (SLE) who developed cellulitis over the left lower leg and had poor response to antibiotics. Two months before this admission, she had sustained a small wound over the right pretibial area and had noticed erythematous swelling after swimming at the beach. Pathologic examination of biopsied tissue showed acid-fast bacilli, and culture yielded M. kansasii. The cellulitis improved gradually during treatment with antimycobacterial agents for 1 year. This case emphasizes the possibility that cutaneous M. kansasii infection may occur in an immunocompromised patient and that exposure to contaminated water is a possible source. With early diagnosis, the response to an antimycobacterial multidrug regimen is usually satisfactory.
authors.affiliation: Department of Pediatrics, Min-Sheng General Hospital, Taipei, Taiwan.
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Hsu
authors.forename: Yao-Hsu
authors.initials: YH
authors.lastname: Yang
authors.forename: Cheng-Hsiang
authors.initials: CH
authors.lastname: Hsiao
authors.forename: Ping-Ing
authors.initials: PI
authors.lastname: Lee
authors.forename: Bor-Luen
authors.initials: BL
authors.lastname: Chiang
mesh_terms: D000328:Adult; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D019909:Mycobacterium kansasii; D012867:Skin / Q000473:pathology; D014871:Water Microbiology