J Korean Med Sci.  2010 Feb;25(2):304-308. 10.3346/jkms.2010.25.2.304.

Disseminated Mycobacterium kansasii Infection Associated with Skin Lesions: A Case Report and Comprehensive Review of the Literature

• Han SH
• Kim KM
• Chin BS
• Choi SH
• Lee HS
• Kim MS
• Jeong SJ
• Choi HK
• Kim CO
• Choi JY
• Song YG
• Kim JM

• KMID: 1779265
• DOI: http://doi.org/10.3346/jkms.2010.25.2.304

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.

Keyword

Mycobacteruim kansasii; Myelodysplastic Syndromes; Skin; Disseminated Infection

MeSH Terms

Antitubercular Agents/therapeutic use
Clarithromycin/therapeutic use
Glucocorticoids/therapeutic use
Humans
Immunocompromised Host
Isoniazid/therapeutic use
Male
Middle Aged
Mycobacterium Infections, Nontuberculous/*diagnosis/drug therapy/immunology
*Mycobacterium kansasii/isolation & purification
Myelodysplastic Syndromes/drug therapy
Rifampin/therapeutic use
Skin Diseases, Bacterial/*diagnosis/immunology/pathology
Sputum/microbiology
Sweet Syndrome/diagnosis
Antitubercular Agents
Glucocorticoids
Rifampin
Isoniazid
Clarithromycin

Figure

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  Fig. 1 Papulonodular skin lesions on lower legs.

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