In this report we describe the case of an immunocompetent patient found to have an endobronchial, ulcerated lesion due to Mycobacterium kansasii. Predisposing factors could have been severe endobronchial stenosis of the main stem bronchi and distortion of the carina, due to healed endobronchial tuberculosis. Diagnosis was set through fiberoptic bronchoscopy and the patient responded well to treatment. Endobronchial non tuberculous mycobacterial infection should be considered in both HIV seropositive and seronegative patients, especially in endemic areas and in the proper clinical setting. Prompt recognition is important for the effective control and prevention of an unfavorable outcome in an otherwise easily treatable disease.

Keywords:
Mycobacterium kansasii, Tuberculosis, Endobronchial ulcer, Fiberoptic bronchoscopy, HIV patients, Immunocompetent patients
1.
Alvarez, et Tavel: Recherches sur le bacille de Lustgarten. Arch Physiol Norm Pathol 1885;3:303.
2.
Viallier J: Isolement de mycobactéries non pathogènes, par culture de l’expectoration des tuberculeux pulmonaires: Leurs caractères distinctifs. Ann Inst Pasteur 1954;37:732.
3.
Chapman JS: The anonymous mycobacteria in human disease. The 6th Annual Ivan H. Mattson I Memorial Conference of the University of Texas Southwestern Medical School and Dallas Tuberculosis Association. Springfield, Thomas, 1960.
4.
Timpe A, Runyon EH: The relationship of ‘atypical’ acid-fast bacteria to human disease. A preliminary report. J Lab Clin Med 1954;44:202–209.
5.
Wolinsky E: Nontuberculous mycobacteria and associated diseases. Am Rev Respir Dis 1979;119:107–159.
6.
O’Brien RJ, Geiter LJ, Snider DE Jr: The epidemiology of nontuberculous mycobacterial diseases in the United States. Results of a national survey. Am Rev Respir Dis 1987;135:1007–1014.
7.
Brown BA, Wallace RJ Jr: Infections due to nontuberculous mycobacteria; in Mandell GL, Bennett JE, Dolin R (eds): Principles and Practices of Infectious Diseases. New York, Churchill Livingstone, 2000, pp 2630–2635.
8.
Horsburgh CR Jr, Selik RA: The epidemiology of disseminated nontuberculous mycobacteria infection in the acquired immunodeficiency syndrome (AIDS). Am Rev Respir Dis 1989;139:4–7.
9.
Wallace RJ Jr, Cook JL, Glassroth J, et al: Diagnosis and treatment of disease caused by nontuberculous mycobacteria. American Thoracic Society Statement. Am J Respir Crit Care Med 1997;156(suppl):S1–S25.
10.
Connolly MG Jr, Baughman RP, Dohn MN: Mycobacterium kansasii presenting as an endobronchial lesion. Am Rev Respir Dis 1993;148:1405–1407.
11.
Quieffin J, Poubeau P, Laaban JP, Brechot JM, Caprot F, Rochemaure J: Mycobacterium kansasii infection as an endobronchial tumor in a patient with the acquired immune deficiency syndrome. Tuber Lung Dis 1994;75:313–315.
12.
Levine B, Chaisson RE: Mycobacterium kansasii: A cause of treatable pulmonary disease associated with advanced human immunodeficiency virus (HIV) infection. Ann Intern Med 1991;114:861–868.
13.
Mehle ME, Adamo JP, Mehta AC, Wiedemann HP, Keys T, Longworth DL: Endobronchial Mycobacterium avium-intracellulare infection in a patient with AIDS. Chest 1989;96:199–201.
14.
Kalayjian RC, Toosi Z, Tomashefski JF Jr, Carey JT, Ross JA, Tomford JW, Blinkhorn RJ Jr: Pulmonary disease due to infection by Mycobacterium avium- complex in patients with AIDS. Clin Infect Dis 1995;20:1186–1194.
15.
Johanson WG Jr, Nicolson DP: Pulmonary disease due to Mycobacterium kansasii. An analysis of some factors affecting prognosis. Am Rev Respir Dis 1969;99:73.
16.
Chung HS, Lee JH: Bronchoscopic assessment of the evolution of endobronchial tuberculosis. Chest 2000;117:385–392.
17.
Watanabe Y, Murakasami S, Oda M, Hayashi Y, Ohta Y, Shimizu J, Kobayashi K, Sato H, Kobayashi H, Nonomura A: Treatment of bronchial stricture due to endobronchial tuberculosis. World J Surg 1997;21:480–487.
18.
Shim YS: Endobronchial tuberculosis. Respirology 1996;1:95–106.
19.
Richter E, Niemann S, Rusch-Gerdes S, Hoffner S: Identification of Mycobacterium kansasii by using DNA probe (AccuProbe) and molecular techniques. J Clin Microbiol 1999;37:964–970.
© 2005 S. Karger AG, Basel
2005
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.