Tuberc Respir Dis.  2013 Oct;75(4):157-160.

A Case of Mycobacterium kansasii Pulmonary Disease Presenting as Endobronchial Lesions in HIV-Infected Patient

• Kim MS
• Han JW
• Jin SS
• Lee JM
• Hah JH
• Kim YJ
• Kim SJ
• Kang MW
• Kang JY

Abstract

Incidence of nontuberculous mycobacterium (NTM) pulmonary disease is increasing with the wider recognition and development of diagnostic technology. Mycobacterium kansasii is the second most common pathogen of NTM pulmonary disease in human immunodeficiency virus (HIV)-infected patients. However in Korea, the incidence of M. kansasii pulmonary disease is relatively low, and there has been no report of M. kansasii pulmonary disease with bronchial involvement in HIV patients, to the best of our knowledge. We report a case of M. kansasii pulmonary disease presenting with endobronchial lesions in an HIV-infected patient complaining of chronic cough with bilateral enlargements of hilar lymph nodes on chest X-ray.

Keyword

Mycobacterium kansasii; Bronchial Diseases; HIV

MeSH Terms

Bronchial Diseases
Cough
HIV
Humans
Incidence
Korea
Lung Diseases*
Lymph Nodes
Mycobacterium kansasii*
Mycobacterium*
Nontuberculous Mycobacteria
Thorax

Figure

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  Figure 1 Initial chest X-ray shows bilateral hilar prominence, raising the possibility of bilateral hilar lymphadenopathy. (B) Follow-up chest X-ray after 18 months-therapy of Mycobacterium kansasii infection shows a complete regression of bilateral hilar lymphadenopathy.

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  Figure 2 Chest computed tomography scan shows multifocal nodular consolidations with some surrounding ground glass opacities in both lungs and several enlarged lymph nodes with some internal low-attenuated lesions in both hilar regions.

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  Figure 3 Bronchoscopic findings show elevated nodular lesions with central whitish necrosis at apical segment of the right upper lobe and luminal narrowing at the apical part of apicoposterior segment of the left upper lobe.

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  Figure 4 (A) Biopsy of bronchial mucosa shows chronic inflammation with ulceration and granulation tissue formation (H&E stain, ×400). (B) Ziehl-Neelsen stain shows positive results (×1,000).

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