Ethambutol-induced bullous skin lesions in mycobacterium kansasii lung infection


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Mycobacterium kansasii is the second most common cause of nontuberculous mycobacterial (NTM) lung disease after Mycobacterium avium complex infection in the United States. [1] 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.



Direct immunofluorescent, Mycobacterium kansasii, drug-induced skin reactions, ethambutol, pemphigus vulgaris, suprabasilar bullous skin lesion, Orphan Drug, Rare Diseases, Tuberculosis, Lung, 2 Aetiology, 2.1 Biological and endogenous factors, Infection