Mycobacterium kansasii infection in a Paris suburb: comparison of disease presentation and outcome according to human immunodeficiency virus status

SETTING: Department of Seine-Saint-Denis, France. OBJECTIVE: To compare the presentation and outcome of Mycobacterium kansasi i 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 in fection between 1991 and 1995. RESULTS: Between 1991 and 1995, 35 cases (23 HIV- [6%] and 12 HIV+ [34%]) w ere found, giving an annual incidence of 0.5/100 000. The following particu larities were common to both groups: 1) frequency and prominence of respira tory and general symptoms, 2) rarity of clinically apparent extra-thoracic involvement, 3) bacteriological confirmation mostly obtained with respirato ry tract specimens, 4) favourable bacteriological outcome, and 5) low morta lity attributable to the mycobacterial infection. The most striking differe nces concerned chest radiography: HIV- patients had apical cavitated and no dular lesions, while HIV+ patients exhibited a variety of other patterns, i ncluding alveolar infiltrates, miliary lesions and/or thoracic lymphadenopa thy. CONCLUSION: Apart from pulmonary radiographic differences, presentation and short-term outcome of M. kansasii infections were similar in HIV+ and HIV- patients.