INFECTIONS DUE TO NONTUBERCULOUS MYCOBACTERIA IN CHILDREN WITH LEUKEMIA

We reviewed the spectrum of infections due to nontuberculous mycobacte ria (NTM) in children with leukemia. Three children acquired such infe ctions. One patient developed pneumonia after the cessation of chemoth erapy when Mycobacterium xenopi was identified in his lung biopsy spec imen. He required 2 years of treatment with antituberculous agents and clarithromycin. Cultures of central and peripheral blood specimens fr om two patients yielded Mycobacterium fortuitum and Mycobacterium chel onae, respectively. Broviac catheters were likely the source of infect ion. Removal of the catheters and antibiotic treatment resulted in cur e. Central venous catheters in leukemic children are potential sources of infection. For febrile neutropenic children with leukemia who do n ot respond to antibiotic therapy, cultures positive for diphtheroids o r negative routine bacterial and fungal cultures should raise a suspic ion for infections due to NTM. Systemic infections may require up to 2 years of therapy. Removal of the infected catheters during persistent or recurrent infections is necessary for control of the infection.