Mycobacterium kansasii infection diagnosed by pleural fluid cytology:a casereport
BACKGROUND: Identification of disseminated nontuberculous Mycobacteriuminfection is a challenge, especially when it occurs in patients without a known cause ofimmunosuppression. Acid-fast organisms in the pleural fluid are rare and easily missed, especiallywhen they occur in patients without a clinical suspicion of infection. The classical cytologicpicture of tuberculous pleural fluid with lymphocytosis and paucity of mesothelial cells is notseen. CASE: A 57-year-old man presented with chronic neutrophilia of unknown etiology together withchest pain and bilateral pleural effusions. Pleural fluid cytology revealed organisms seen in thecytoplasm of numerous macrophages and neutrophils, creating a “negative image” on Diff-Quik smears.Acid-fast stains demonstrated intracellular acid-fast bacilli consistent with mycobacteria.Microbiologic studies with DNA probe technology resulted in identification of the mycobacterialorganism as Mycobacterium kansasii. CONCLUSION: Nontuberculous Mycobacterium should be included inthe differential diagnosis in patients with inflammatory, exudative pleural effusions.
Domfeh,AB　Nodit,L　Gradowski,JF　Bastacky,S
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh,Pennsylvania, and University of Alabama, Birmingham, Alabama 15213, USA.
Liquid substance　 Fast　 Organisms (MeSH Category) Acids
