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; Bum Sik Chin

doi:10.3947/ic.2012.44.6.526

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Park, Lee, Min, Jung, Jeon, Shin, and Chin: A Case of Mycobacterium kansasii Lymphadenitis in HIV-infected Patient

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(6): 526-529.

Published online: 31 December 2012

DOI: https://doi.org/10.3947/ic.2012.44.6.526

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, 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, moberrer@hanmail.net

Received 10 July 2012 Revised 14 September 2012 Accepted 26 September 2012

(open-access):

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 and Tables

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).

Table 1

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

M, male; F, female; LN, lymph node; INH, isoniazid; RFP, rifampin; EMB, ethambutol; PZA, pyrazinamide; AML, acute myeloid leukemia; VZV, varicella zoster virus.

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