Mycobacterial pulmonary infection post allogeneic bone marrow transplantation

Allogeneic bone marrow transplant recipients are prone to pulmonary infecti ons caused by a wide spectrum of organisms. Since the first bone marrow tra rnsplatation (BMT) done in 1983 at the Tate Memorial Hospital, we have rece ntly seen the first case of Mycobacterium Fortuitum Chelonae complex among 117 BMT (including 90 allogeneic and 27 autologous) patients. The patient w as on immunosuppressants for chronic GVHD post allogeneic BMT done for CML- CP. He developed pulmonary mycobacterial infection 13 months post BMT. Diag nosis was difficult because of the atypical presentation. negative culture reports. and the presence of multiple pathogens due to immunosuppression. I n our case the diagnosis was eventually established after examination of ma terial obtained by bronchoscopy. Patient has shown response to antitubercul osis drugs after 2 months. This shows the need to consider atypical mycobac terial infection in the differential diagnosis of pulmonary illness in the post allogeneic BMT setting.