A Case of Severe Mycobacterium kansasii Infection Complicated with the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

Abstract

We present a case of severe Mycobacterium kansasii infection due to the clinical and radiological progression and complicated with syndrome of inappropriate antidiuretic hormone secretion (SIADH). This 54-year-old male alcoholic and heavy smoker as predisposing factors presented severe anorexia, asthenia and cachexia. Abundant acid-fast bacilli (AFB) were observed in the patient's sputum and pleural fluid after Ziehl-Neelsen (ZN) staining. The strain was identified as M. kansasii by culture. A treatment with isoniazid, pyrazinamide, ethambutol, clarithromycin and moxifloxacin were then initiated. The course of the illness includes impaired consciousness, behavioural disturbances and agitation; we believe was a consequence of SIADH, because of the severe hyponatremia with low serum osmolality condition. Also, generalized or local infections are important and unregarded causes of SIADH. Multiple infectious diseases are associated with this syndrome [1]. An awareness of this pathogen with clinical, radiologic, and microbiologic parameters are all needed to establish the diagnosis of this infection and the eradication of disease requires prolonged combination drug therapy.