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        Dr  Sampurna Roy  MD

 
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Mycobacterium kansasii is a slow-growing photochromogenic mycobacterium causing infection in patients with AIDS, but has also been identified in HIV negative patients. Visit: Atypical Mycobacterial Infection ; Mycobacterium Marinum Infection.

After Mycobacterium Avium Intracellulare, Mycobacterium kansasii is the second most common non-tuberculous infection in patients with AIDS.  This important mycobacterial pathogen usually infects patients late in the course of AIDS. 

 Visit: Cutaneous lesion associated with AIDS ; AIDS related malignant tumours  ;  Mycobacterium Leprae Inf.  ;  Mycobacterium ulcerans Inf.

It can cause pulmonary infection in patients with predisposing lung diseases, such as chronic obstructive pulmonary disease, bronchiectasis, pneumonoconiosis, previous tuberculosis  or bronchogenic carcinoma.

South African gold miners with a background of silicosis or old tuberculous scarring have increased susceptibility to this infection, which is most often found in the lungs.

Disseminated infections, mainly in immunosuppressed patients, also occur.

Various other clinical settings have been described including involvement of skin and skeletal system. It can cause various focal infections, such as osteomyelitis, gastrointestinal infection, gingivomandibular disease, appendicitis, and brain abscess.

The disease is usually acquired after contact with infected water and there is often a history of concomitant trauma.

Typically M. kansasii infections show granulomatous inflammation associated in some instances with acute inflammatory changes and necrosis.

According one study five types of reactions were seen - (i) abscesses; (ii) granulomas without giant cells but with large areas of central eosinophilic necrosis with numerous neutrophils and nuclear debris ;  (iii) well-organized granulomas without giant cells or necrosis, but with a mononuclear cell infiltrate ; (iv) areas of eosinophilic granular necrosis with scattered clusters of epithelioid histiocytes ; (v) and spindle-cell proliferations with scattered clusters of neutrophils.  According to another study a sixth pattern has been recorded - (vi) that of sheets of foamy histiocytes containing AFB.

The bacilli have a distinctive appearance when compared to other mycobacteria, being larger, broader and more coarsely beaded.

Special stains:  Both  Mycobacterium Avium Intracellulare and  Mycobacterium kansasii stain with periodic acid–Schiff, although staining appears more intense with MAC.

                   

Abstracts:

Mycobacterium kansasii olecranon bursitis.J Med Microbiol. 2006 Dec;55(Pt 12):1745-6.

Disseminated Mycobacterium kansasii infection in an HIV-negative patient presenting with mimicking multiple bone metastases.Diagn Microbiol Infect Dis. 2006 Mar;54(3):211-6. Epub 2006 Jan 19

Pathologic features of Mycobacterium kansasii infection in patients with acquired immunodeficiency syndrome.Arch Pathol Lab Med. 2003 May;127(5):554-60

Mycobacterium kansasii infections in patients with cancer.Clin Infect Dis. 2000 Jun;30(6):965-9

Mycobacterium kansasii infection in patients infected with the human immunodeficiency virus.Eur J Clin Microbiol Infect Dis. 1999;18(8):582-6

Mycobacterium kansasii infection in a Paris suburb: comparison of disease presentation and outcome according to human immunodeficiency virus status. Groupe dEtude Des Mycobacteries de la Seine-Saint-Denis.Int J Tuberc Lung Dis. 1999 Jan;3(1):68-73

Clinical manifestations and implications of coinfection with Mycobacterium kansasii and human immunodeficiency virus type 1.Clin Infect Dis. 1995 Jul;21(1):77-85

Mycobacterium kansasii among patients infected with human immunodeficiency virus in Kansas City. Kansas City AIDS Research Consortium.Clin Infect Dis. 1994 Mar;18(3):395-400

Mycobacterium kansasii pulmonary infection: a prospective study of the results of nine months of treatment with rifampicin and ethambutol. Research Committee, British Thoracic Society.Thorax. 1994;49(5):442-5

The spectrum of Mycobacterium kansasii disease associated with HIV-1 infected patients.J Acquir Immune Defic Syndr. 1991;4(5):516-20.

 
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