FATAL MYCOBACTERIUM-AVIUM COMPLEX DISEASE IN A PATIENT WITH ACUTE NONLYMPHOBLASTIC LEUKEMIA

Purpose: The objective of this article was to present the diagnosis of a fatal infection by Mycobacterium avium complex (MAC) in a child wit h acute myelogenous leukemia, a disease rarely reported in non-HIV inf ected children. Methods: Specific identification of MAC was made by cu lture in BACTEC system from an open lung biopsy. Results: A 5-year-old girl diagnosed with acute nonlymphoblastic leukemia was admitted beca use of fever during the maintenance phase after achieving a complete r emission of her malignancy. A mild dry cough started on day 4 of admis sion, and a chest roengenogram revealed a pulmonary infiltrate. An ins idious respiratory distress developed and mechanical ventilation was u ndertaken. An open-lung biopsy, carried out on day 10 of ventilatory s upport, revealed acid-fast bacilli subsequently grown as MAC. In spite of combined antimycobacterial treatment. the patient followed a downh ill course and died on day 41 of hospitalization. Conclusion: This rep ort describes a new case of fatal MAC infection in an immunocompromise d, non-HIV infected child. MAC must be added to the list of infectious microorganisms that can infect children with acute nonlymphoblastic l eukemia. As modem immunosuppressive therapeutic modalities evolve, it is likely that MAC will become a more common and recognized pathogen i n the immunocompromised child.