Kollipara Venkateswara K, Horowitz Mitchell, Lantz Jeffery, Nagy-Agren Stephanie
Department of Pulmonary and Critical Care; Salem VA Medical Center, Salem, VA; Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
Department of Pulmonary and Critical Care; Salem VA Medical Center, Salem, VA, USA.
Int J Mycobacteriol. 2022 Jan-Mar;11(1):120-122. doi: 10.4103/ijmy.ijmy_204_21.
Mycobacterium kansasii is the second most common cause of nontuberculous mycobacterial (NTM) lung disease after Mycobacterium avium complex infection in the United States. The first-line therapy for M. kansasii is a three-drug regimen including rifampin, isoniazid, and ethambutol. We present a case of a patient with pulmonary M. kansasii who developed bullous skin lesions while receiving this regimen and again after rechallenge with ethambutol. In patients with intolerance to one of the first-line antibiotics, a multidisciplinary team approach to starting second-line agents is needed. Ethambutol should be included in the differential diagnosis of drug-induced bullous skin lesions in treated patients with NTM, who develop new onset rash with blisters or ulceration.
堪萨斯分枝杆菌是美国非结核分枝杆菌（NTM）肺病的第二大常见病因，仅次于鸟分枝杆菌复合群感染。堪萨斯分枝杆菌的一线治疗方案是包含利福平、异烟肼和乙胺丁醇的三联用药方案。我们报告了一例肺部感染堪萨斯分枝杆菌的患者，该患者在接受此治疗方案期间出现了大疱性皮肤病变，再次使用乙胺丁醇激发试验后又再次出现。对于不耐受一线抗生素之一的患者，需要多学科团队协作来启动二线药物治疗。在接受NTM治疗且出现新发水疱或溃疡皮疹的患者中，药物性大疱性皮肤病变的鉴别诊断应包括乙胺丁醇。
