Mycobacterium Kansasii Infection Overlying Tattoo Pigment in an Immunocompromised Patient

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Rohit Gupta
Jennifer Martin
Carina Wasko


Mycobacterium kansasii, atypical mycobacterium, immunocompromised, bacterial infection, tattoo


The incidence of atypical mycobacterial infections has steadily grown over the past decades, and it is well-known that the risk of progressive disease increases with immunodeficiency. While rare, tattoo pigment can serve as a nidus for atypical mycobacterium infection in immunocompromised individuals. Here, we present a case of a 41-year-old immunocompromised female who presented with verrucous plaques overlying long-standing tattoos in multiple locations. The patient’s lesions were biopsied and sent for board-range polymerase chain reaction revealing infection with Mycobacterium kansasii, a slow-growing atypical mycobacterium that rarely causes cutaneous disease without systemic symptoms. Early recognition and treatment of cutaneous M. kansasii is important to prevent progression of disease.


1. Bhambri S, Bhambri A, Del Rosso JQ. Atypical mycobacterial cutaneous infections. Dermatol Clin. 2009;27(1):63-73. doi:10.1016/j.det.2008.07.009

2. Khan K, Wang J, Marras TK. Nontuberculous mycobacterial sensitization in the United States: national trends over three decades. Am J Respir Crit Care Med. 2007;176(3):306-313. doi:10.1164/rccm.200702-201OC

3. Mudedla S, Avendano EE, Raman G. Non-tuberculous mycobacterium skin infections after tattooing in healthy individuals: A systematic review of case reports. Dermatol Online J. 2015;21(6).

4. Conaglen PD, Laurenson IF, Sergeant A, Thorn SN, Rayner A, Stevenson J. Systematic review of tattoo-associated skin infection with rapidly growing mycobacteria and public health investigation of a cluster in Scotland, 2010. Euro Surveill. 2013;18(32):20553. doi:10.2807/1560-7917.es2013.18.32.20553

5. Akram SM, Rawla P. Mycobacterium Kansasii. In: StatPearls. Treasure Island (FL)2020.

6. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367-416. doi:10.1164/rccm.200604-571ST

7. Breathnach A, Levell N, Munro C, Natarajan S, Pedler S. Cutaneous Mycobacterium kansasii infection: case report and review. Clin Infect Dis. 1995;20(4):812-817. doi:10.1093/clinids/20.4.812

8. Hsu PY, Yang YH, Hsiao CH, Lee PI, Chiang BL. Mycobacterium kansasii infection presenting as cellulitis in a patient with systemic lupus erythematosus. J Formos Med Assoc. 2002;101(8):581-584.

9. Sprague J, Leibowitz M, Chiu MW. Cutaneous infection with Mycobacterium kansasii in a patient with myelodysplastic syndrome and Sweet syndrome. Cutis. 2015;96(1):E10-12.

10. Han SH, Kim KM, Chin BS, et al. Disseminated Mycobacterium kansasii infection associated with skin lesions: a case report and comprehensive review of the literature. J Korean Med Sci. 2010;25(2):304-308. doi:10.3346/jkms.2010.25.2.304