HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maliwan, N Articles by Zvetina, J R Search for Related Content PubMed PubMed Citation Articles by Maliwan, N Articles by Zvetina, J R

Clinical features and follow up of 302 patients with Mycobacterium kansasii pulmonary infection: a 50 year experience

¹ Loyola University Medical Center, Maywood, Illinois, USA
² Abraham Lincoln School of Medicine, University of Illinois, USA

Correspondence to:
Correspondence to:
Dr N Maliwan
PO Box 1017, VAH, Hines, Illinois 60141, USA; pitsanulok{at}aol.com

Aims: To analyse clinical features and treatment outcomes of patients with pulmonary Mycobacterium kansasii infection treated at Hines VA Hospital between 1952 and 1995, and followed up until 2003.

Findings: 302 patients were confirmed to have M kansasii pulmonary infection; diagnosis was not made until death in 2%. The average age was 50 years old; 76% were white; all were men. Productive cough, dyspnoea, and chest pain were common; 16% were asymptomatic. Right sided, apical or subapical, thin walled cavitary infiltrate was the characteristic radiological feature. Heavy smoking, chronic obstructive pulmonary disease, alcoholism, peptic ulcer disease, coronary artery disease, prior tuberculosis, psychosis, prior pneumonia, and immunocompromising conditions were prevalent. Average follow up was 10 years and 2 months. PPD was positive in 58% of 179 tested. Two thirds of the patients required only first line drugs. Fourteen per cent required surgical intervention, none after 1977. Spontaneous resolution occurred in 1%. Aspergillosis developed in 4%. Bronchogenic carcinoma coexisted with M kansasii infection in 6% and followed it in 4%. Extrapulmonary malignancy coexisted with the infection in 4% and followed it in 6%; most involved head and neck. Eleven per cent of 224 deaths were attributed to M kansasii. Outcomes were affected by comorbidity, treatment compliance, rifampicin use, and extent of infection.

Conclusions: Prognosis of M kansasii pulmonary infection is good if diagnosed and treated early, together with control of underlying conditions. Clinicians should be aware of atypical radiological manifestations of the disease when coexisting with other pulmonary or immunocompromising conditions.

Keywords: Mycobacterium kansasii; mycobacterium infections; atypical; atypical mycobacterium infections; pulmonary diseases

This article has been cited by other articles:

				L. B. Gadkowski and J. E. Stout Cavitary Pulmonary Disease Clin. Microbiol. Rev., April 1, 2008; 21(2): 305 - 333. [Abstract] [Full Text] [PDF]

				A. Cattamanchi, P. Nahid, T. K. Marras, M. B. Gotway, T. J. Lee, L. C. Gonzalez, A. Morris, W. R. Webb, D. H. Osmond, and C. L. Daley Detailed Analysis of the Radiographic Presentation of Mycobacterium kansasii Lung Disease in Patients With HIV Infection Chest, April 1, 2008; 133(4): 875 - 880. [Abstract] [Full Text] [PDF]

				J. Glassroth Pulmonary Disease Due to Nontuberculous Mycobacteria Chest, January 1, 2008; 133(1): 243 - 251. [Abstract] [Full Text] [PDF]