title: Fatal aortic pseudoaneurysm from disseminated Mycobacterium kansasii infection: case report.
abstract: Mycobacterium kansasii is a photochromogenic, slow-growing mycobacterium species that can cause pulmonary infection in patients with predisposing lung diseases, as well as extrapulmonary or disseminated disease in immunosuppressed patients. We describe a patient with a myelodysplastic syndrome, disseminated M kansasii infection, and ruptured aortic aneurysm. He had a recent diagnosis of mycobacterium cavitary lung lesions and was transferred to our facility for possible surgical intervention of an aortic aneurysm. Few hours after admission, the patient suddenly collapsed and died despite resuscitation efforts. A complete autopsy was performed and showed ruptured ascending aortic pseudoaneurysm with hemopericardium, disseminated necrotizing and nonnecrotizing granulomas with acid-fast bacilli in the aortic wall, lungs, heart, liver, spleen, and kidneys. Further genetic studies were consistent with monocytopenia and mycobacterial infection syndrome.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322. Electronic address: laleh.ehsani@emory.edu.
authors.forename: Laleh
authors.initials: L
authors.lastname: Ehsani
authors.affiliation: Division of Infectious Diseases, Emory University, Atlanta, GA 30322.
authors.forename: Sujan C
authors.initials: SC
authors.lastname: Reddy
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322.
authors.forename: Mario
authors.initials: M
authors.lastname: Mosunjac
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322; Division of Infectious Diseases, Emory University, Atlanta, GA 30322.
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Kraft
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA 30322; Division of Infectious Diseases, Emory University, Atlanta, GA 30322. Electronic address: jguarne@emory.edu.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Guarner
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000382:microbiology* / Q000473:pathology; D000785:Aneurysm, Infected / Q000473:pathology; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000473:pathology*; D001014:Aortic Aneurysm / Q000382:microbiology* / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003933:Diagnosis; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D055613:Multiple Pulmonary Nodules / Q000150:complications*; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D019909:Mycobacterium kansasii / Q000302:isolation & purification*
keywords: Aortic pseudoaneurysm; GATA2; Granuloma; MonoMAC syndrome; Mycobacterium kansasii; Myelodysplastic syndrome