DISSEMINATED MYCOBACTERIUM-MALMOENSE INFECTION IN A PATIENT WITH CHRONIC GRANULOCYTIC-LEUKEMIA

Mycobacterium malmoense is an atypical mycobacterium previously isolat ed from lymph nodes in children and from adults with pulmonary disease . Disseminated infection is extremely rare and bone marrow involvement has never previously been described. We report a patient with chronic granulocytic leukaemia and persistent fever with granuloma in the bon e marrow due to disseminated M. malmoense infection. The patient initi ally received treatment with isoniazid, ethambutol and rifampicin with clearance of mycobacteria in the bone marrow and clinical improvement . Sensitivity in vitro was established for streptomycin, amikacin, eth ambutol and rifabutin. The patient eventually expired as a result of p rogressive respiratory failure from other opportunistic infections. At autopsy staining of samples from lung parenchyma revealed fungal hyph i but staining for Pneumocystis carinii and myobacteria were negative.