Cutaneous Mycobacterium kansasii infection in a patient with AIDS post initiation of antiretroviral therapy

Abstract

The HIV pandemic has resulted in unique clinical presentations in patients, and their diagnosis and management pose challenges to physicians in the developing world. Due to limited resources and difficulties in laboratory diagnosis, most physicians treat according to the most likely etiological agent that might be causing the disease. In South Africa, when acid-fast bacilli are detected, anti-tuberculous treatment is commenced. However, it must be realized that not all acid-fast bacilli are Mycobacterium tuberculosis, and that there are nontuberculous mycobacteria that can cause infections. Clinicians should work closely with the medical microbiologist when unique cases arise to ensure optimal microbial detection, identification, and patient management. This paper describes a very rare case of self-resolving cutaneous Mycobacterium kansasii infection following the initiation of antiretroviral therapy and potentially associated with immune reconstitution inflammatory syndrome.

HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management

“…Localized or primary cutaneous infections have also been reported as sporotrichoid eruptions and abscesses (157)(158)(159). Mycobacterium kansasii rarely primarily inoculates the skin but has been reported as pustules, papules, nodules, abscesses, and ulcers (160)(161)(162)(163). In patients with arthritis and painful purulent cutaneous lesions, Mycobacterium haemophilum should be considered.…”

Understanding cutaneous tuberculosis: two clinical cases

“…A major challenge is the differential diagnosis of cutaneous TB from other skin infections such as leishmaniasis, leprosy, chromomycosis, sporotrichosis and granulomatous and verrucous lesions of different origins (Bhutto et al , 2002), though cutaneous infections caused by non-tuberculous mycobacteria (NTM) are those that can be more often confused with cutaneous TB (Mitha et al , 2011) because of the clinical features and population target. It has been noted that NTM infections may develop following traumatic injury, surgery or cosmetic procedures (Bhambri et al , 2009; Hautmann & Lotti, 1994; Liao et al , 2007; Lotti & Hautmann, 1993).…”

Tuberculosis of Finger Presenting As Non-healing Ulcer of Digit: A Case Report

“…The differential diagnosis of cutaneous infections includes infections caused by non-tuberculous mycobacteria (NTM) apart from cutaneous TB [11]. NTM infections can occur as a result of a traumatic injury, surgery, or cosmetic procedure [12].…”