title: Disseminated Mycobacterium kansasii infection associated with skin lesions: a case report and comprehensive review of the literature.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Han
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Bum Sik
authors.initials: BS
authors.lastname: Chin
authors.forename: Suk Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Han Sung
authors.initials: HS
authors.lastname: Lee
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jeong
authors.forename: Hee Kyoung
authors.initials: HK
authors.lastname: Choi
authors.forename: Chang Oh
authors.initials: CO
authors.lastname: Kim
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Choi
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Song
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents; D005938:Glucocorticoids; D017291:Clarithromycin; D007538:Isoniazid; D012293:Rifampin