Fatal Mycobacterium avium Complex Disease in a Patient with Acute Nonlymphoblastic Leukemia

Abstract

This report describes a new case of fatal MAC infection in an immunocompromised, non-HIV infected child. MAC must be added to the list of infectious microorganisms that can infect children with acute nonlymphoblastic leukemia. As modern immunosuppressive therapeutic modalities evolve, it is likely that MAC will become a more common and recognized pathogen in the immunocompromised child.

Critical Pulmonary Infection Due to Nontuberculous Mycobacterium in Pediatric Leukemia

“…The radiologic findings in NTM infections, including MAC, are nonspecific, and possible presentations may vary between slowly progressive lung nodulations or bronchiectasis and fibrocavitatory lung disease leading to rapid respiratory failure. 2,8,9 Moreover, in our report, an NTM infection sustained by MAC was recognized by lung tissue biopsy using PCR. 12 In other cases, microbiological isolation of NTM in cultures from biological fluids can be difficult and definitive etiological diagnosis requires more invasive investigations.…”

Atypical cause of prolonged myelosuppression

“…Optimum treatment duration is not defined, but infection is most frequently treated for 12–18 months. M chelonae is frequently reported as causing infection in patients with cystic fibrosis,2 – 4 erythroleukaemia,5 chronic lymphocytic leukaemia6 and paediatric acute non-lymphoblastic leukaemia,7 and in haematopoietic stem cell transplantation recipients8 (including catheter related infection),9 , 10 cord blood stem cell transplantation recipients11 and allogeneic bone marrow transplantation recipients 12. It has also frequently been reported to cause fever in neutropenic patients 13.…”