Mycobacterium kansasiiin East Kent : A report of seven pulmonary infections with an environmental study

Abstract

Seven cases of lung infection by M. kansasii have been found in South-East Kent during 1963 to 1967. One patient has died. All were male cigarette smokers aged 44 years or more and 6 inhabited the port of Dover. Five had marked pre-existing pulmonary emphysema and one had pneumoconiosis. The epidemiology of M. kansasii infections is not understood. Although one of the 7 cases had pulmonary lesions of 14 years' duration and had a positive sputum for 4 years, he could not be incriminated as the source for 5 cases in the same town. M. kansasii could not be found in the environment, despite a wide search. Lung disease caused by M. kansasii resembles tuberculosis, with symptoms less severe than might be expected from its extent. It seems probable that many patients do not require treatment with drugs. Like most cases reported in the literature, 2 of the series recovered on chemotherapy which was ineffective in vitro . Three recovered without chemotherapy of any kind. Beyond persistence of the organism in the sputum, there were no features to distinguish patients likely to develop progressive disease requiring chemotherapy (cycloserine and ethionamide). It was noted that 2 men, more disabled than the others by pre-existing emphysema, were those whose infection was most difficult to control.