Mycobacterium kansasii infection in a Paris suburb: comparison of disease presentation and outcome according to human immunodeficiency virus status
OBJECTIVE: To compare the presentation and outcome of Mycobacterium kansasii infections according to human immunodeficiency virus (HIV) status.
DESIGN: Retrospective analysis of all the medical charts of adults meeting the diagnostic criteria of the American Thoracic Society for M. kansasii infection between 1991 and 1995.
RESULTS: Between 1991 and 1995, 35 cases (23 HIV− [6%] and 12 HIV+ [34%]) were found, giving an annual incidence of 0.5/100000. The following particularities were common to both groups: 1) frequency and prominence of respiratory and general symptoms, 2) rarity of clinically apparent extra-thoracic involvement, 3) bacteriological confirmation mostly obtained with respiratory tract specimens, 4) favourable bacteriological outcome, and 5) low mortality attributable to the mycobacterial infection. The most striking differences concerned chest radiography: HIV− patients had apical cavitated and nodular lesions, while HIV+ patients exhibited a variety of other patterns, including alveolar infiltrates, miliary lesions and/or thoracic lymphadenopathy.
CONCLUSION: Apart from pulmonary radiographic differences, presentation and short-term outcome of M. kansasii infections were similar in HIV+ and HIV− patients.
Document Type: Regular Paper
Affiliations: 1: Service de Médecine Interne et Centre de Recherche en Pathologie Infectieuse et Tropicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, Bobigny, France 2: Service de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, Bobigny, France 3: Service de Médecine Interne, Hôpital Général Robert-Ballanger, Aulnay-sous-Bois, France 4: Laboratoire de Bactériologie, Hôpital Général Robert-Ballanger, Aulnay-sous-Bois, France 5: Laboratoire de Pneumologie, Hôpital Général Robert-Ballanger, Aulnay-sous-Bois, France 6: Laboratoire de Bactériologie-Virologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, Bobigny, France 7: Laboratoire Départemental, Conseil Général de la Seine-Saint-Denis, Bondy, France 8: INSERM U82, Faculté Xavier-Bichat, Paris, France 9: Laboratoire de Référence des Mycobactéries, Institut Pasteur, Paris, France 10: Service de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Université Paris-Nord, Bobigny, France; and INSERM U82, Faculté Xavier-Bichat, Paris, France
Publication date: 01 January 1999
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