Disseminated Mycobacterium kansasii infection associated with skin lesions: a case report and comprehensive review of the literature

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 take...

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Bibliographic Details
Published in:Journal of Korean medical science 2010, 25(2), 135, pp.304-308
Main Authors: Han, Sang Hoon, Kim, Kyoung Min, Chin, Bum Sik, Choi, Suk Hoon, Lee, Han Sung, Kim, Myung Soo, Jeong, Su Jin, Choi, Hee Kyoung, Kim, Chang Oh, Choi, Jun Yong, Song, Young Goo, Kim, June Myung
Format: Article
Language:English
Subjects:
Antitubercular Agents - therapeutic use
Case Report
Clarithromycin - therapeutic use
Glucocorticoids - therapeutic use
Humans
Immunocompromised Host
Isoniazid - therapeutic use
Male
Middle Aged
Mycobacterium Infections, Nontuberculous - diagnosis
Mycobacterium Infections, Nontuberculous - drug therapy
Mycobacterium Infections, Nontuberculous - immunology
Mycobacterium kansasii - isolation & purification
Myelodysplastic Syndromes - drug therapy
Rifampin - therapeutic use
Skin Diseases, Bacterial - diagnosis
Skin Diseases, Bacterial - immunology
Skin Diseases, Bacterial - pathology
Sputum - microbiology
Sweet Syndrome - diagnosis
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Summary: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.
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2010.25.2.304