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Pathology of  Mycobacterium Kansasii Infection

Dr Sampurna Roy MD

 

                                                                                                                      

 

 

Mycobacterium kansasii is a slow-growing photochromogenic mycobacterium causing infection in patients with acquired immunodeficiency syndrome (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 acquired immunodeficiency syndrome.  

This important mycobacterial pathogen usually infects patients late in the course of acquired immunodeficiency syndrome. 

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 Mycobacterium 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) 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 Acid Fast Bacilli;

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 Mycobacterium avium complex.

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

Further reading:

Mycobacterium kansasii olecranon bursitis.

Disseminated Mycobacterium kansasii infection in an HIV-negative patient presenting with mimicking multiple bone metastases.

Pathologic features of Mycobacterium kansasii infection in patients with acquired immunodeficiency syndrome.

Mycobacterium kansasii infections in patients with cancer.

Mycobacterium kansasii infection in patients infected with the human immunodeficiency virus.

Mycobacterium kansasii infection in a Paris suburb: comparison of disease presentation and outcome according to human immunodeficiency virus status.  

Clinical manifestations and implications of coinfection with Mycobacterium kansasii and human immunodeficiency virus type 1.

Mycobacterium kansasii among patients infected with human immunodeficiency virus in Kansas City.  

Mycobacterium kansasii pulmonary infection: a prospective study of the results of nine months of treatment with rifampicin and ethambutol. Research Committee,  

The spectrum of Mycobacterium kansasii disease associated with HIV-1 infected patients.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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