<i>Mycobacterium kansasii</i>: A Cause of Treatable Pulmonary Disease Associated with Advanced Human Immunodeficiency Virus (HIV) Infection
Authors: Beth Levine, Richard E. Chaisson
Journal: Annals of Internal Medicine (1991)

Article15 May 1991Mycobacterium kansasii: A Cause of Treatable Pulmonary Disease Associated with Advanced Human Immunodeficiency Virus (HIV) InfectionBeth Levine, MD, Richard E. Chaisson, MDBeth Levine, MDSearch for more papers by this author, Richard E. Chaisson, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-10-861 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptObjective: To assess the clinical features and response to therapy of Mycobacterium kansasii infection in patients with human immunodeficiency virus (HIV) infection.Design: We reviewed the records of all patients with M. kansasii and HIV infection treated between January 1985 and June 1990.Setting: The Johns Hopkins Hospital, Baltimore, Maryland.Results: Nineteen patients with M. kansasii and HIV infection were identified; 14 patients had exclusive pulmonary infection, 3 patients had pulmonary and extrapulmonary infection, and 2 patients had exclusive extrapulmonary infection. At the time of diagnosis of M. kansasii infection, the median CD4+ lymphocyte count was 49 cells/µL (range, 0 to 198 cells/µL), and 16 of 19 patients had a previous diagnosis of the acquired immunodeficiency syndrome (AIDS). All 17 patients with pulmonary infection presented with fever and cough of at least 2 weeks duration. Chest radiographs showed either focal upper lobe infiltrates (n = 8) or diffuse interstitial infiltrates (n = 9); 9 patients also had thin-walled cavitary lesions. Nine patients with pulmonary M. kansasii infection were treated with antituberculosis chemotherapy, with resolution of fever and respiratory symptoms, improvement of radiographic infiltrates, and sputum conversion; 1 patient with M. kansasii osteomyelitis also responded to antituberculosis therapy. Autopsies done on 3 treated patients did not reveal any evidence of M. kansasii infection. Nine patients did not receive any antituberculosis chemotherapy; 2 untreated patients developed progressive cavitary pulmonary disease and died from M. kansasii pneumonia.Conclusions: Mycobacterium kansasiicauses serious and potentially life-threatening pulmonary disease in patients with advanced HIV-related immunosuppression. In contrast to previous reports, our findings indicate that disease produced byM. kansasiiin patients with HIV infection is responsive to antituberculosis chemotherapy....References1. PitchenikColeRussellFischlSpiraSnider ACBMTD. Tuberculosis, atypical mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in south Florida. Ann Intern Med. 1984;101:641-5. LinkGoogle Scholar2. ChaissonSchecterTheuerRutherfordEchenbergHopewell RGCGDP. Tuberculosis in patients with the acquired immunodeficiency syndrome. Clinical features, response to therapy, and survival. Am Rev Respir Dis. 1987;136:570-4. 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Valainis, MD 15 May 1991Volume 114, Issue 10Page: 861-868KeywordsAIDSChemotherapyFeversHIVHIV infectionsInfectious diseasesPulmonary diseasesThoraxUpper respiratory tract infectionsVentilators Issue Published: 15 May 1991 Copyright© 1991 American College of PhysiciansPDF DownloadLoading ...