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Critical Pulmonary Infection Due to Nontuberculous Mycobacterium in Pediatric Leukemia: Report of a Difficult Diagnosis and Review of Pediatric Series

Arlotta, Annalisa MD; Cefalo, Maria G. MD; Maurizi, Palma MD; Ruggiero, Antonio MD; Dodi, Icilio MD; Riccardi, Riccardo MD

Journal of Pediatric Hematology/Oncology: January 2014 - Volume 36 - Issue 1 - p 66–70
doi: 10.1097/MPH.0b013e3182841737
Clinical and Laboratory Observations

Nontuberculous mycobacterial infections are rare but severe complications of chemotherapy in children. In children with prolonged lymphopoenia after mieloablative regimens, symptoms can be nonspecific and fever and pulmonary impairment are the most common clinical features. Diagnosis is challenging for physicians and microbiologists and often requires invasive techniques. We report a girl affected by acute lymphoblastic leukemia, who developed a disseminated infection sustained by Mycobacterium avium complex. Identification of the microorganism was obtained by open lung biopsy and evidence of mycobacterium genome. We also reviewed 15 literature cases of disseminated infections of nontuberculous mycobacterium in children with leukemia.

*Department of Paediatric Sciences, Division of Paediatric Oncology, Catholic University of Rome, Rome

Department of Mother and Child, Division of Paediatric Oncology and Infectious Diseases, University Hospital of Parma, Parma, Italy

A.A. and C.M.G. contributed equally.

The authors declare no conflict of interest.

Reprints: Annalisa Arlotta, MD, Department of Pediatric Sciences, Division of Pediatric Oncology, Catholic University of Rome, Largo A.Gemelli 8, Roma 00168, Italy (e-mail:

Received February 1, 2012

Accepted December 19, 2012

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