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Huge cutaneous abscess and severe symptomatic hypercalcaemia secondary to Mycobacterium kansasii infection in an immunocompetent patient
  1. Sarocha Vivatvakin1,2,
  2. Kamalas Amnuay3 and
  3. Chusana Suankratay3
  1. 1 Department of Internal Medicine, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  2. 2 Department of Physiology, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  3. 3 Division of Infectious Disease, Department of Internal Medicine, Chulalongkorn University Faculty of Medicine, Bangkok, Thailand
  1. Correspondence to Professor Chusana Suankratay; csuankratay{at}gmail.com

Abstract

Mycobacterium kansasii is among the most common non-tuberculous mycobacteria causing human infections. Apart from pulmonary infection, the most common infection caused by M. kansasii is skin and soft tissue infection, and it is very rare in immunocompetent people. In this report, we present a case of a huge cutaneous abscess caused by M. kansasii. A 63-year-old man living in Bangkok presented with progressive pain at the left lateral chest wall for 3 weeks and altered mentation for a few days. Examination revealed a non-tender fluctuated cutaneous mass 20×10 cm in size. An aspiration of the mass yielded 50 mL pus with many positive acid-fast bacilli. Mycobacterial PCR was positive for M. kansasii with culture confirmation. There was severe hypercalcaemia. The treatment included surgical drainage, and medical treatment consisted of isoniazid, rifampicin, ethambutol and levofloxacin, along with adequate hydration and calcitonin for hypercalcaemia. The patient gradually improved and was discharged 12 days after hospitalisation.

  • calcium and bone
  • infectious diseases
  • TB and other respiratory infections

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Footnotes

  • Contributors SV, KA and CS were involved in conceptualisation. SV and KA were involved in acquisition or interpretation of data. SV was involved in drafting of the manuscript. SV, KA and CS were involved in critical revision of the manuscript for important intellectual content. KA was involved in administrative, technical or material support. CS was involved in supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.