pISSN 2093-2340   eISSN 2092-6448
Indexed in ESCI, PubMed, Scopus, DOAJ and more
Open Access, Peer-reviewed
    Infect Chemother. 2012 Dec;44(6):526-529. Korean.
    Published online Dec 31, 2012.
    https://doi.org/10.3947/ic.2012.44.6.526
    Copyright © 2012 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy
    Case Report

    A Case of Mycobacterium kansasii Lymphadenitis in HIV-infected Patient

    Seon Young Park, Ga Ram Lee, Ji Won Min, Ja Young Jung, Young Do Jeon, Hyoung-Shik Shin and Bum Sik Chin
      • Department of Internal Medicine, National Medical Center, Seoul, Korea.
    • Correspondence to Bum Sik Chin, M.D. Department of Internal Medicine, National Medical Center, 18-79 Euljiro 6-ga, Jung-gu, Seoul 100-799, Korea. Tel: +82-2-2260-4748, Fax: +82-2-2268-0803, Email: moberrer@hanmail.net
    Received July 10, 2012; Revised September 14, 2012; Accepted September 26, 2012.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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).

    Keywords
    Mycobacterium kansasii; Lymphadenitis; Human immunodeficiency virus

    Figures

    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).

    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).

    Tables

    Table 1
    Clinical Characteristics of Patients with Localized M. kansasii Lymphadenitis on Previously Published Literatures

    References

      1. Koh WJ, Kwon OJ. Treatment of nontuberculous mycobacterial pulmonary diseases. Tuberc Respir Dis 2004;56:5–17.
      1. Koh WJ, Kwon OJ. Diagnosis and treatment of nontuberculous mycobacterial lung disease. Korean J Med 2008;74:120–131.
      1. Kim JH, Suh JT, Park SY, Lee HJ, Lee WI. Clinical evaluation of 10 cases of nontuberculous mycobacteria isolated from sputum. Korean J Lab Med 2004;24:49–52.
      1. Park HJ, Yu H, Choi SH, Sung H, Hong JP, Kim JJ, Lee SO. A case of Mycobacterium kansasii cutaneous infection in a heart transplant recipient. Korean J Med 2011;81:121–125.
      1. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr, Winthrop K. ATS Mycobacterial Diseases Subcommittee; American Thoracic Society; Infectious Disease Society of America. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367–416.
      1. Reddy VC, Prasad CE, Aparna S, Gokhale S, Anjeneyulu. A study of mycobacterial species causing lymphadenitis. Southeast Asian J Trop Med Public Health 2008;39:130–135.
      1. Santin M, Alcaide F. Mycobacterium kansasii disease among patients infected with human immunodeficiency virus type 1: improved prognosis in the era of highly active antiretroviral therapy. Int J Tuberc Lung Dis 2003;7:673–677.
      1. Stellbrink HJ, Koperski K, Albrecht H, Greten H. Mycobacterium kansasii infection limited to skin and lymph node in a patient with AIDS. Clin Exp Dermatol 1990;15:457–458.
      1. Kotb R, Dhote R, Garcia-Ricart F, Permal S, Carlotti A, Arfi C, Christoforov B. Cutaneous and Mediastinal Lymphadenitis due to Mycobacterium kansasii. J Infect 2001;42:277–278.
      1. Saritsiri S, Udomsantisook N, Suankratay C. Nontuberculous mycobacterial infections in King Chulalongkorn Memorial Hospital. J Med Assoc Thai 2006;89:2035–2046.
      1. The Korean Academy of Tuberculosis and Respiratory Diseases. Treatment guidelines for tuberculosis. 4th ed. 2005. pp. 142-143.
      1. Hung SC, Chang SC. New pulmonary lesions during therapy for extrapulmonary tuberculosis. Chest 1999;116:1794–1797.
      1. Song JY, Cheong HJ. Diagnosis and treatment of cervical lymphadenitis from a standpoint of infectious disease specialists. Infect Chemother 2008;40:76–82.
      1. DeSimone JA, Pomerantz RJ, Babinchak TJ. Inflammatory reactions in HIV-1-infected persons after initiation of highly active antiretroviral therapy. Ann Intern Med 2000;133:447–454.
    Cited by
    Crossref 2
    Google Scholar 
    MeSH Terms
    Antiretroviral Therapy, Highly Active
    Drainage
    HIV
    Humans
    Immunocompromised Host
    Immunosuppression Therapy
    Korea
    Lamivudine
    Lung Diseases
    Lymphadenitis
    Mycobacterium
    Mycobacterium kansasii
    Nontuberculous Mycobacteria
    Metrics
    Share
    Figures
    slide
    slide

    1 / 2

    Tables
    slide

    1 / 1

    PERMALINK