A Case Report: Diagnosis of Mycobacterium kansasii Infection by tNGS in a Patient With Parkinson’s Disease

Infections caused by nontuberculous mycobacteria (NTM), especially Mycobacterium kansasii, are characterized by nonspecific clinical manifestations. Moreover, their radiological features frequently overlap with those of both tuberculosis (TB) infections and lung cancer, which significantly complicates the differential diagnosis. We present a case of a patient with Parkinson’s disease (PD) who was admitted with cough and sputum production and dyspnea. Chest computed tomography (CT) revealed atelectasis, multiple solid nodules, osteolytic lesions in multiple ribs, and pleural effusion. The initial diagnostic evaluation raised the suspicion of a lung cancer with multiple bone metastases. While acid‐fast staining (AFS) of biopsy tissue was positive, polymerase chain reaction (PCR) for TB was negative. Ultimately, targeted next‐generation sequencing (tNGS) of sputum detected M. kansasii , considering the diagnosis of pulmonary M. kansasii infection. This case highlights the need to consider M. kansasii infection in atypical imaging findings and the utility of tNGS for diagnosis when conventional tests are inconclusive.