Mycobacterium kansasii osteomyelitis – a masquerading disease

Bhatt, Kiranmai; Banavathi, Krishna

doi:10.1099/jmmcr.0.005114

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Osteopathy is a rare sequela of such M. kansasii infections that commonly manifest as osteomyelitis. Only seven such cases involving immunocompetent individuals have been documented in the literature, of which four involving the spine are identical to our case [6][7][8][9][10][11][12]. Here, we describe a rare case of an immunocompetent patient who had a diagnosed systemic M. kansasii infection with spinal involvement and show her imaging performance before (Figure 1) and after (Figure 2) admission.…”

supporting

confidence: 62%

Multiple Bone Destruction Secondary to Mycobacterium kansasii Pulmonary Disease: A Case Report

Dai

Zhou

et al. 2023

Diagnostics

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Mycobacterium kansasii infections predominantly manifest in immunocompromised people and are primarily responsible for lung disease and systemic disseminated infection. Osteopathy is a rare consequence of M. kansasii infection. Here, we present imaging data from a 44-year-old immunocompetent Chinese woman diagnosed with multiple bone destruction, particularly of the spine, secondary to M. kansasii pulmonary disease, which is easily misdiagnosed. The patient underwent an emergency operation after experiencing unexpected incomplete paraplegia during hospitalization, indicating an aggravation of bone destruction. Preoperative sputum testing and next-generation sequencing of DNA and RNA of intraoperative samples confirmed the diagnosis of M. kansasii infection. Treatment with anti-tuberculosis therapy and the subsequent patient response supported our diagnosis. Given the rarity of osteopathy secondary to M. kansasii infection in immunocompetent individuals, our case offers some insight into this diagnosis.

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confidence: 62%

Multiple Bone Destruction Secondary to Mycobacterium kansasii Pulmonary Disease: A Case Report

Dai

Zhou

et al. 2023

Diagnostics

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“…Finally, microbiological criteria for the diagnosis are (i) two positive cultures from two separated sputum samples, or (ii) positive culture from one bronchoalveolar lavage (BAL), or (iii) mycobacterial histopathological findings on the lung biopsies and one positive culture (of sputum or BAL). In addition, M. kansasii can also cause skin, soft tissues, and osteoarticular infections in both immunocompetent and immunocompromized patients [ 4 ]. In some very sporadic cases, M. kansasii can also be found in the urine [ 5 ], sometimes with pathogenic manifestations [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Pathogenic Determinants of the Mycobacterium kansasii Complex: An Unsuspected Role for Distributive Conjugal Transfer

et al. 2021

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The Mycobacterium kansasii species comprises six subtypes that were recently classified into six closely related species; Mycobacterium kansasii (formerly M. kansasii subtype 1), Mycobacterium persicum (subtype 2), Mycobacterium pseudokansasii (subtype 3), Mycobacterium ostraviense (subtype 4), Mycobacterium innocens (subtype 5) and Mycobacterium attenuatum (subtype 6). Together with Mycobacterium gastri, they form the M. kansasii complex. M. kansasii is the most frequent and most pathogenic species of the complex. M. persicum is classically associated with diseases in immunosuppressed patients, and the other species are mostly colonizers, and are only very rarely reported in ill patients. Comparative genomics was used to assess the genetic determinants leading to the pathogenicity of members of the M. kansasii complex. The genomes of 51 isolates collected from patients with and without disease were sequenced and compared with 24 publicly available genomes. The pathogenicity of each isolate was determined based on the clinical records or public metadata. A comparative genomic analysis showed that all M. persicum, M. ostraviense, M innocens and M. gastri isolates lacked the ESX-1-associated EspACD locus that is thought to play a crucial role in the pathogenicity of M. tuberculosis and other non-tuberculous mycobacteria. Furthermore, M. kansasii was the only species exhibiting a 25-Kb-large genomic island encoding for 17 type-VII secretion system-associated proteins. Finally, a genome-wide association analysis revealed that two consecutive genes encoding a hemerythrin-like protein and a nitroreductase-like protein were significantly associated with pathogenicity. These two genes may be involved in the resistance to reactive oxygen and nitrogen species, a required mechanism for the intracellular survival of bacteria. Three non-pathogenic M. kansasii lacked these genes likely due to two distinct distributive conjugal transfers (DCTs) between M. attenuatum and M. kansasii, and one DCT between M. persicum and M. kansasii. To our knowledge, this is the first study linking DCT to reduced pathogenicity.

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“…Besides the pathogenicity and isolation source diversity, MKC species display heterogeneity regarding phenotypic aspects such as virulence, colony morphology and drug resistance. For example, regarded to virulence, pulmonary disease underlying respiratory comorbidities or immunosuppression is the main clinical manifestation of human infections caused by MKC, although the occurrence of extrapulmonary diseases is also observed 4,5 . Furthermore, lung disease caused by M. kansasii can result in a broad pathology spectrum 6 .…”

Section: Introductionmentioning

confidence: 99%

Phylogenomic and genomic analysis reveals unique and shared genetic signatures of Mycobacterium kansasii complex species

Machado,

Vasconcellos,

Gomes

et al. 2024

Preprint

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Species belonging to the Mycobacterium kansasii complex (MKC) are frequently isolated from humans and the environment and can cause serious diseases. The most common MKC infections are caused by the species M. kansasii (stricto sensu), leading to tuberculosis-like disease. However, a broad spectrum of virulence, antimicrobial resistance and pathogenicity of these non-tuberculous mycobacteria (NTM) are observed across the MKC. Many genomic aspects of the MKC that relate to these broad phenotypes are not well elucidated. Here, we performed genomic analyses from a collection of 665 MKC strains, isolated from environmental, animal and human sources. We inferred the MKC pangenome, mobilome, resistome, virulome and defense systems and show that the MKC species harbors unique and shared genomic signatures. High frequency of presence of prophages and different types of defense systems was observed. We found that the M. kansasii species splits into four lineages, of which three are lowly represented and mainly in Brazil, while one lineage is dominant and globally spread. Moreover, we show that four sub-lineages of this most distributed M. kansasii lineage emerged during the 20th century. Further analysis of the M. kansasii genomes revealed almost 300 regions of difference contributing to genomic diversity, as well as fixed mutations that may explain the M. kansasii's increased virulence and drug resistance.

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Mycobacterium kansasii osteomyelitis – a masquerading disease

Cited by 9 publications

References 18 publications

Multiple Bone Destruction Secondary to Mycobacterium kansasii Pulmonary Disease: A Case Report

Multiple Bone Destruction Secondary to Mycobacterium kansasii Pulmonary Disease: A Case Report

Pathogenic Determinants of the Mycobacterium kansasii Complex: An Unsuspected Role for Distributive Conjugal Transfer

Phylogenomic and genomic analysis reveals unique and shared genetic signatures of Mycobacterium kansasii complex species

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