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Fig. 30.9 Disseminated ulcerated lesions caused by M. kansasii in an HIV-infected patient. |
M. kansasii is a photochromogenic acid-fast bacillus. It is found worldwide, including in the U.S.—particularly in the Southwest and the Midwest. The most common presentation is a pulmonary infection resembling tuberculosis, typically in older men with chronic obstructive pulmonary disease. Cutaneous presentation is heterogenous and includes an ulcer with sporotrichoid spread or cellulitis. It has a predilection for HIV-infected individuals (Fig. 30-9). In HIV-infected individuals, almost all colonized patients have disease and require treatment with ethambutol or rifampin.