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• W3206086130 abstract "TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Nontuberculous mycobacteria (NTM) species are mycobacterial species other than those belonging to the Mycobacterium tuberculosis complex. Mycobacterium kansasii, is the second most frequently recognized NTM pathogen and second most frequent cause of disseminated disease. The same diagnostic criteria apply to the diagnosis of pulmonary infection with M. kansasii as to MAC infection. This slow-growing acid-fast bacillus can be seen in 90% of patients as a cavitary lesion in the upper lung zones, resembling M. tuberculosis. It is most commonly seen in males with an average age range between 45-62 years old and is geographically dominant in the southeastern and central United States. Major risk factor for the disease include chronic obstructive pulmonary disease, HIV infection, pneumoconiosis and malignancy. CASE PRESENTATION: We present the case of a 43 year old male with medical history of Hepatitis C and HIV not on antiretroviral therapy who was brought to the emergency department with complains of general malaise, shortness of breath, and productive cough of 2 weeks of evaluation. Associated symptoms included dysphagia and odynophagia. Denied nausea, vomiting, chills, fever or night sweats. Vital signs remarkable for tachypnea and hypothermia. Physical examination showed marked cachexia, oral thrush, right neck violaceous scar measuring approximately 2cm and diffuse bilateral rhonchi. Laboratory showed mild leukopenia (WBC: 4), lymphopenia and marked toxic granulation. Chemistry showed preserved renal function and no major electrolyte disturbances. LDH slightly elevated 223 and normal procalcitonin (0.15). Patient found with CD4: 3uL, reactive Hepatitis C and VDRL positive 1/128 dilution. Chest CT Scan showed left upper lobe cavitary lesion measuring approximately 1.7 x 2.6 cm with bilateral pulmonary nodules present with associated consolidative changes towards the left lung base. Given above findings and patient immunosuppressive state, patient was placed on isolation and empirically treated for mycobacterium tuberculosis. Tuberculin skin test revealed a negative result. Sputum acid fast and culture grow M. kansasii . Skin biopsy of the purpuric lesions consistent with Kaposi sarcoma. Patient was managed with Rifampin, Azithromycin and Ethambutol. DISCUSSION: The aim of this case, is to provide medical awareness of pulmonary M. Kansasii as a possible differential diagnosis in cases of lung cavitary lesions as those of suspected Tuberculosis or space occupying lesions with associated nonspecific symptoms. CONCLUSIONS: M. kansasii causes pulmonary manifestations similar to tuberculosis in immunocompetent patients and pulmonary, extrapulmonary, or disseminated disease in patients with HIV. Blood culture isolates should always be considered pathogenic. Prognosis of M kansasii pulmonary disease has good prognosis if diagnosed and treated early, along with control of underlying disorders. REFERENCE #1: Kim MS, Han JW, Jin SS, et al. A Case of Mycobacterium kansasii Pulmonary Disease Presenting as Endobronchial Lesions in HIV-Infected Patient. Tuberc Respir Dis (Seoul). 2013;75(4):157-160. doi:10.4046/trd.2013.75.4.157 REFERENCE #2: Johnston JC, Chiang L, Elwood K. Mycobacterium kansasii. Microbiol Spectr. 2017 Jan;5(1). doi: 10.1128/microbiolspec.TNMI7-0011-2016. PMID: 28185617. DISCLOSURES: No relevant relationships by Vanessa Fonseca Ferrer, source=Web Response No relevant relationships by Abbud Haydar, source=Web Response No relevant relationships by Ivanisse Ortiz Velez, source=Web Response No relevant relationships by Danielle Perez Zamora, source=Web Response No relevant relationships by Neshma Roman-Velez, source=Web Response No relevant relationships by Monica Rosado-Jimenez, source=Web Response No relevant relationships by Gustavo Santiago Borges, source=Web Response No relevant relationships by Sharon Velez-Maymi, source=Web Response" @default.
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• W3206086130 date "2021-10-01" @default.
• W3206086130 modified "2023-10-18" @default.
• W3206086130 title "SHATTERED LUNGS: A RARE CASE OF A PULMONARY CAVITARY LESION BY MYCOBACTERIUM KANSASII" @default.
• W3206086130 doi "https://doi.org/10.1016/j.chest.2021.07.422" @default.
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