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Mycobacterium kansasii
Causes HIV-associated mycobacterial infection.
Epidemiology:
1) more prevalent in patients form midwestern USA
2) more prevalent in injection drug users
3) environmental source: ? water, ? animals
Pathology:
1) cavitary pneumonia indistinguishable from tuberculosis
2) disseminated infection
2) extrapulmonary disease frequently involves the GI tract
a) infiltrative disease of the liver & small bowel
b) intra-abdominal lymphadenopathy
Clinical manifestations:
- pulmonary infection resembles tuberculosis
- cough, fever, weight loss
Laboratory:
1) CD4 count is generally < 200/mm3
2) recovery & identification of organism in infected tissue & respiratory secretions
3) Mycobacterium kansasii rRNA
4) also see Mycobacterium
Management:
1) rifampin, ethambutol & isoniazid
2) relatively resistant to isoniazid
3) duration of therapy: 12 months or longer
4) empiric antibiotic therapy for Mycobacterial infection in a patients with advanced HIV infection
a) isoniazid
b) rifampin
c) pyrazinamide
d) ethambutol
e) clarithromycin
General
Mycobacterium
Properties
KINGDOM: monera
DIVISION: SCHIZOMYCETES
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16,
17. American College of Physicians, Philadelphia 1998, 2009,
2012 2015
- Harrison's Principles of Internal Medicine, 13th ed.
Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 722