Mycobacterium kansasii
infection has been reported to be about 20 percent of non-tuberculous mycobacteriosis, and its disseminated type is uncommon and the prognosis is reported to be generally poor. We experienced one case of disseminated Mycobacterium kansasii
infection. A 81 year-old man who had been
short-bowel syndrome due to the operation for superior mesenteric artery occlusion since 1998 was admitted on April 24th, 2001 to our hospital because of slowly progressive consciousness disturbance and
anorexia. He had shown progressive productive
cough and
respiratory failure and laboratory findings were
C-reactive protein elevation and
pancytopenia. Human immunodeficiency virus (HIV) antibody was negative. Chest X-ray and computed tomography showed diffuse miliary nodules and infiltrative shadow. Sputum examination was positive for mycobacteria. The cultured isolate was identified as Mycobacterium kansasii. Bone marrow aspirations revealed inflammatory
granuloma with
necrosis. He was diagnosed as disseminated Mycobacterium kansasii
infection and
heart failure, and was treated by
anti-tuberculosis drugs and
diuretics. Treatment was very effective and Chest X-ray findings and
respiratory failure had been completely improved. In this case we speculated that the
malnutrition due to
short-bowel syndrome could be one of the most suspected reasons of Mycobacterium kansasii dissemination. Disseminated Mycobacterium kansasii
infection has been rarely reported comparing with the other mycobacterial
infections in Japan. However, due to the increasing numbers of immunocompromised hosts with aging,
HIV infection,
cancer, and
steroid therapy, this type of
infection will become more common and its earlier diagnosis and adequate treatment will be important to improve the prognosis.