Infect Chemother.  2012 Dec;44(6):526-529. 10.3947/ic.2012.44.6.526.

A Case of Mycobacterium kansasii Lymphadenitis in HIV-infected Patient

• Park SY
• Lee GR
• Min JW
• Jung JY
• Jeon YD
• Shin HS
• Chin BS

• KMID: 1806948
• DOI: http://doi.org/10.3947/ic.2012.44.6.526

Abstract

Nontuberculous mycobacteria (NTM) are widely present in the environment, although they rarely cause infection in humans. However, infection by NTM has been increasingly recognized worldwide in the context of the human immunodeficiency virus (HIV) epidemic and therapeutic immunosuppression. Mycobacterium kansasii is a slow-growing photochromogenic mycobacterium, which mainly causes pulmonary infection in patients with predisposing lung diseases, and, occasionally, disseminated infection with poor outcomes in immunocompromised patients. We report on the first case of lymphadenitis caused by infection with M.kansasii in an HIV-infected patient in Korea. The patient showed significant improvement after receiving antituberculous therapy (isoniazid, rifabutin) in combination with surgical drainage and highly active antiretroviral therapy (abacavir, lamivudine, and lopinavir/ritonavir).

Keyword

Mycobacterium kansasii; Lymphadenitis; Human immunodeficiency virus

MeSH Terms

Antiretroviral Therapy, Highly Active
Drainage
HIV
Humans
Immunocompromised Host
Immunosuppression
Korea
Lamivudine
Lung Diseases
Lymphadenitis
Mycobacterium
Mycobacterium kansasii
Nontuberculous Mycobacteria
Lamivudine

Figure

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  Figure 1 Computed tomography shows a central low density with peripheral rim enhancement in the left submandibular lymph node. Follow-up imaging (B, on hospital day 12) shows an increase in size despite antituberculous therapy, compared with the initial study (A, on hospital day 2).

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  Figure 2 (A) A few poorly formed granulomas and polymorphous lymphoid cells are seen in submandibular lymph node aspirates (H&E stain, ×400). (B) Long, beaded acid-fast bacilli are seen in submandibular lymph node aspirates (Ziehl-Neelsen stain, ×1,000).

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