To evaluate the frequency, clinical features, and prognosis of patients with osteitis caused by bacille Calmette-Guérin (BCG) vaccination, medical records from Finnish children based on nationwide registration from 1960 to 1988 were retrospectively analyzed. During the study period, three different BCG vaccine preparations were used. In 222 children, diagnostic criteria of BCG osteitis were fulfilled. The age at onset of BCG osteitis varied from 0.25 to 5.7 years. The most common sites of osteitis were metaphyses of the long bones. The lower extremity (58%) was affected more often than the upper (14%). Osteitis was situated in the sternum in 36 patients (15%) and in the ribs in 27 (11%). The frequency of BCG osteitis, but not the clinical parameters, was closely associated with the vaccine preparation used. Only 6 children were left with some sequelae. With adequate treatment, the prognosis for children vaccinated with BCG is good.

An epidemic of mild pneumonia was discovered during a chest radiographic survey of adolescents and young adults in two communities 110 kilometers apart in northern Finland. Antibodies to chlamydial antigens were found in 32 of 34 persons with pneumonitis. Microimmunofluorescence antibody tests suggest that the etiologic agent is closely related or identical to TW-183, an unusual strain of Chlamydia psittaci isolated from the eye of a child in Taiwan. The point prevalence of pneumonitis with antibody to TW-183 in school children at the time of the survey was high-15 and 19 patients per 1,000 students in the two communities. There was no evidence of avian transmission in the epidemic.

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The growth of Mycobacterium malmoense is dysgonic and slow on ordinary mycobacterium media. The effect of pH and pyruvate on the growth of ten strains was studied on a modification of Löwenstein-Jensen medium. Growth appeared sooner and was more abundant at pH less than 6.5. At pH 7 or higher, it was scarcely or not at all visible after six weeks of incubation. Pyruvate enhanced the growth of five strains that grew only poorly on glycerol-containing medium, even at acidic pH. The parallel use of both pyruvate and glycerol-containing media, pH 6 to 6.5, and an incubation period of seven weeks or longer are recommended for the isolation of Mycobacterium malmoense on Löwenstein-Jensen medium.

Mycobacterium triplex, a recently described slowly growing nontuberculous mycobacterium, was isolated from a Finnish patient with pulmonary mycobacteriosis. The disease was successfully treated with antimycobacterial drugs. The strain isolated, which was similar to the type strain but differed slightly from the species description, was regarded as a variant of M. triplex sensu stricto. According to present knowledge this variant of the species has never been isolated before.Recent advances in diagnostic methodology for mycobacteria other than Mycobacterium tuberculosis (MOTT), and new possibilities introduced for drug therapy of the diseases they induce, have renewed interest in mycobacterial research. The recognition that most patients with AIDS are at high risk of complications and/or terminal illness caused by MOTT has further stimulated research efforts. The principles of diagnosis and therapy of diseases caused by MOTT have also recently been updated by the American Thoracic Society (1). These guidelines include recommendations for specific drug regimens which recognize the major impact of the newer chemotherapeutic agents.Improved diagnostic means allow enhanced detection and more-accurate species identification of mycobacteria isolated from clinical specimens, including the classification of species not recognized earlier. In 1996, Floyd et al. (5) characterized a new species of slow-growing MOTT, which they designated Mycobacterium triplex. The primary characterization of this novel species was based on conventional testing, but the conclusive genetic evidence relied on 16S rRNA analyses. Although the species is uncommon, it was found to be geographically widespread in the United States (5). There is one very recent report of M. triplex in Europe (4).We isolated M. triplex from a Finnish patient suffering from pulmonary mycobacteriosis. M. triplex was the only mycobacterium isolated from the specimens. As illustrated in this paper, the strain found in this patient differed slightly from the earlier description of the species. To our knowledge, this is the first report of a pulmonary disease associated with M. triplex.Case report. A 67-year-old, human immunodeficiency virusnegative dentist presented in hospital with hemoptysis in 1995. On chest radiographs, thin fibrotic changes were detected in both lower fields, but no cavitary changes were detected. Highresolution computed tomography (HRCT), performed in December 1995, revealed multifocal bronchiectases in both lungs and multiple small nodules in the middle and lower lobes of the right lung and the lower lobe of the left lung, indicating mycobacteriosis (1). Bronchoscopy showed nonspecific inflammatory mucosal changes on the right side. Smears of sputum and bronchoalveolar lavage specimens were negative for acidfast bacilli, but cultures of sputum samples taken on three successive days grew a slow-growing mycobacterium. It was identified using conventional tests, gas-liquid chromatographic (GLC) analysis of cellular fatty acid and alcohol composition, ...

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