Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1996 Dec;51(12):1243–1247. doi: 10.1136/thx.51.12.1243

Pulmonary Mycobacterium kansasii infection: comparison of radiological appearances with pulmonary tuberculosis.

A J Evans 1, A J Crisp 1, R B Hubbard 1, A Colville 1, S A Evans 1, I D Johnston 1
PMCID: PMC472771  PMID: 8994523

Abstract

BACKGROUND: A study was undertaken to determine if there are differences in the radiological appearances at presentation between pulmonary infections caused by Mycobacterium kansasii and Mycobacterium tuberculosis. Correct recognition of the organism has important implications with regard to initial therapy and contact tracing. METHODS: The initial chest radiographs of 28 patients with pulmonary M kansasii infection were compared with those of 56 age, sex, and race matched patients with M tuberculosis infection. All patients in both groups were culture positive and none was known to be HIV positive. The radiographs were analysed independently by two radiologists who were unaware of the causative organism. RESULTS: Radiographic abnormalities in patients with M kansasii infection were more frequently unilateral and right side predominant, while those with tuberculosis more frequently involved a lower lobe. Air space shadowing involving more than one bronchopulmonary segment and pleural effusions were seen less frequently in M kansasii infection (four of 28 (14%) versus 30 of 56 (54%) and none of 28 versus 15 of 56 (27%)). Cavitation (21 of 28 (75%) versus 34 of 56 (61%) was seen to a similar extent in patients with M kansasii infection and in those with tuberculosis. Cavities tended to be smaller in patients with M kansasii infection (p < 0.01). CONCLUSIONS: Differences are seen in the radiographic appearances of pulmonary infection caused by M kansasii and M tuberculosis. These differences are not sufficient to allow a positive diagnosis on the basis of radiographic findings alone, but the presence of a pleural effusion or lower lobe involvement makes M kansasii infection very unlikely.

Full text

PDF
1247

Images in this article

1244Image
on p.1244
1245Image
on p.1245
1245Image
on p.1245
1245Image
on p.1245

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albelda S. M., Kern J. A., Marinelli D. L., Miller W. T. Expanding spectrum of pulmonary disease caused by nontuberculous mycobacteria. Radiology. 1985 Nov;157(2):289–296. doi: 10.1148/radiology.157.2.4048433. [DOI] [PubMed] [Google Scholar]
  2. Anderson D. H., Grech P., Townshend R. H., Jephcott A. E. Pulmonary lesions due to opportunist mycobacteria. (Review includes 30 cases of M. kansasii infections). Clin Radiol. 1975 Oct;26(4):461–469. doi: 10.1016/s0009-9260(75)80097-3. [DOI] [PubMed] [Google Scholar]
  3. Banks J., Hunter A. M., Campbell I. A., Jenkins P. A., Smith A. P. Pulmonary infection with Mycobacterium kansasii in Wales, 1970-9: review of treatment and response. Thorax. 1983 Apr;38(4):271–274. doi: 10.1136/thx.38.4.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Buckner C. B., Leithiser R. E., Walker C. W., Allison J. W. The changing epidemiology of tuberculosis and other mycobacterial infections in the United States: implications for the radiologist. AJR Am J Roentgenol. 1991 Feb;156(2):255–264. doi: 10.2214/ajr.156.2.1898796. [DOI] [PubMed] [Google Scholar]
  5. Christensen E. E., Dietz G. W., Ahn C. H., Chapman J. S., Murry R. C., Anderson J., Hurst G. A. Initial roentgenographic manifestations of pulmonary Mycobacterium tuberculosis, M kansasii, and M intracellularis infections. Chest. 1981 Aug;80(2):132–136. doi: 10.1378/chest.80.2.132. [DOI] [PubMed] [Google Scholar]
  6. Christensen E. E., Dietz G. W., Ahn C. H., Chapman J. S., Murry R. C., Hurst G. A. Radiographic manifestations of pulmonary Mycobacterium kansasii infections. AJR Am J Roentgenol. 1978 Dec;131(6):985–993. doi: 10.2214/ajr.131.6.985. [DOI] [PubMed] [Google Scholar]
  7. Davies P. D. Infection with Mycobacterium kansasii. Thorax. 1994 May;49(5):435–436. doi: 10.1136/thx.49.5.435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Evans A. J., Crisp A. J., Colville A., Evans S. A., Johnston I. D. Pulmonary infections caused by Mycobacterium malmoense and Mycobacterium tuberculosis: comparison of radiographic features. AJR Am J Roentgenol. 1993 Oct;161(4):733–737. doi: 10.2214/ajr.161.4.8372747. [DOI] [PubMed] [Google Scholar]
  9. Horsburgh C. R., Jr, Selik R. M. The epidemiology of disseminated nontuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS). Am Rev Respir Dis. 1989 Jan;139(1):4–7. doi: 10.1164/ajrccm/139.1.4. [DOI] [PubMed] [Google Scholar]
  10. Lichtenstein I. H., MacGregor R. R. Mycobacterial infections in renal transplant recipients: report of five cases and review of the literature. Rev Infect Dis. 1983 Mar-Apr;5(2):216–226. doi: 10.1093/clinids/5.2.216. [DOI] [PubMed] [Google Scholar]
  11. Lillo M., Orengo S., Cernoch P., Harris R. L. Pulmonary and disseminated infection due to Mycobacterium kansasii: a decade of experience. Rev Infect Dis. 1990 Sep-Oct;12(5):760–767. doi: 10.1093/clinids/12.5.760. [DOI] [PubMed] [Google Scholar]
  12. Marinelli D. L., Albelda S. M., Williams T. M., Kern J. A., Iozzo R. V., Miller W. T. Nontuberculous mycobacterial infection in AIDS: clinical, pathologic, and radiographic features. Radiology. 1986 Jul;160(1):77–82. doi: 10.1148/radiology.160.1.3715048. [DOI] [PubMed] [Google Scholar]
  13. Mycobacterium kansasii pulmonary infection: a prospective study of the results of nine months of treatment with rifampicin and ethambutol. Research Committee, British Thoracic Society. Thorax. 1994 May;49(5):442–445. doi: 10.1136/thx.49.5.442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sherer R., Sable R., Sonnenberg M., Cooper S., Spencer P., Schwimmer S., Kocka F., Muthuswamy P., Kallick C. Disseminated infection with Mycobacterium kansasii in the acquired immunodeficiency syndrome. Ann Intern Med. 1986 Nov;105(5):710–712. doi: 10.7326/0003-4819-105-5-710. [DOI] [PubMed] [Google Scholar]
  15. Woodring J. H., Vandiviere H. M. Pulmonary disease caused by nontuberculous mycobacteria. J Thorac Imaging. 1990 Apr;5(2):64–76. doi: 10.1097/00005382-199004000-00009. [DOI] [PubMed] [Google Scholar]
  16. Zvetina J. R., Demos T. C., Maliwan N., Van Drunen M., Frederick W., Lentino J., Modh A. M. Pulmonary cavitations in Mycobacterium kansasii: distinctions from M. tuberculosis. AJR Am J Roentgenol. 1984 Jul;143(1):127–130. doi: 10.2214/ajr.143.1.127. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES