Disseminated Mycobacterium kansasii infection with cutaneous lesions in an immunocompetent patient

Int J Infect Dis. 2017 Sep:62:59-63. doi: 10.1016/j.ijid.2017.07.006. Epub 2017 Jul 14.

Abstract

A case of disseminated Mycobacterium kansasii infection involving the skin and soft tissue in a 57-year-old male farmer who presented with recurrent fever, respiratory syndromes, and skin lesions is reported. The positive findings of syndromes, laboratory examinations, and identification of M. kansasii in puncture fluid indicated the diagnosis of disseminated M. kansasii infection involving the skin and soft tissue, lungs, and mediastinal lymph nodes. After applying the standard HRE regimen (isoniazid 300mg/day, rifampicin 600mg/day, and ethambutol 750mg/day), the patient's temperature normalized and his symptoms improved gradually. No notable adverse drug reactions occurred and the skin lesions had healed after 4 months of follow-up. Disseminated M. kansasii infections occur mainly in immunocompromised patients. Moreover, disseminated infections with skin lesions is rare in immunocompetent patients. Following a review of the literature, only eight similar cases were identified as of disseminated M. kansasii infection with cutaneous lesions, and thecase presented here appears to be the second involving an immunocompetent individual. Special attention should be paid to a persistent and chronic rash following a chronic respiratory syndrome in order to exclude skin disease caused by non-tuberculous mycobacteria.

Keywords: Cutaneous lesions; Disseminated Mycobacterium kansasii infection.

Publication types

  • Case Reports

MeSH terms

  • Drug Therapy, Combination
  • Ethambutol / therapeutic use
  • Humans
  • Immunocompetence
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / immunology
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Mycobacterium Infections, Nontuberculous / pathology*
  • Mycobacterium kansasii*
  • Rifampin / therapeutic use
  • Skin / pathology*
  • Skin Diseases, Bacterial / microbiology
  • Skin Diseases, Bacterial / pathology*

Substances

  • Ethambutol
  • Isoniazid
  • Rifampin