Disseminated Mycobacterium kansasii infection associated with skin lesions: a case report and comprehensive review of the literature.
Mycobacteruim kansasii occasionally causes disseminated infection with poor outcome in immunocompromised patients. We report the first case of disseminated M. kansasii infection associated with multiple skin lesions in a 48-yr-old male with myelodysplastic syndrome. The patient continuously had taken glucocorticoid during 21 months and had multiple skin lesions developed before 9 months without complete resolution until admission. Skin and mediastinoscopic paratracheal lymph node (LN) biopsies showed necrotizing granuloma with many acid-fast bacilli. M. kansasii was cultured from skin, sputum, and paratracheal LNs. The patient had been treated successfully with isoniazid, rifampin, ethmabutol, and clarithromycin, but died due to small bowel obstruction. Our case emphasizes that chronic skin lesions can lead to severe, disseminated M. kansasii infection in an immunocompromised patient. All available cases of disseminated M. kansasii infection in non HIV-infected patients reported since 1953 are comprehensively reviewed.
Han
Sang Hoon
SH
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kim
Kyoung Min
KM
Chin
Bum Sik
BS
Choi
Suk Hoon
SH
Lee
Han Sung
HS
Kim
Myung Soo
MS
Jeong
Su Jin
SJ
Choi
Hee Kyoung
HK
Kim
Chang Oh
CO
Choi
Jun Yong
JY
Song
Young Goo
YG
Kim
June Myung
JM
D000995:Antitubercular Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D019909:Mycobacterium kansasii / Q000302:isolation & purification; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D012293:Rifampin / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D013183:Sputum / Q000382:microbiology; D016463:Sweet Syndrome / Q000175:diagnosis
D000995:Antitubercular Agents; D005938:Glucocorticoids; D017291:Clarithromycin; D007538:Isoniazid; D012293:Rifampin