Document 0448
 DOCN  M9650448
 TI    First case of disseminated Mycobacterium avium infection following
       chemotherapy for childhood acute myeloid leukemia.
 DT    9605
 AU    Claass A; Claviez A; Westphal E; Rusch-Gerdes S; Schneppenheim R;
       Institut fur Immunologie, Christian-Albrechts-Universitat,; Kiel,
       Germany.
 SO    Infection. 1995 Sep-Oct;23(5):301-2. Unique Identifier : AIDSLINE
       MED/96128592
 AB    A 14-year-old girl of Indian origin with acute myeloid leukemia (AML) is
       presented, who was diagnosed at the age of twelve. Antileukemic
       chemotherapy had to be discontinued after 6 weeks because of persistent
       high fever and the emergence of liver and spleen abscesses. Serologic
       and biopsy findings were consistent with disseminated candidiasis;
       however, a liver biopsy also revealed granulomatous lesions with caseous
       degeneration. No acid-fast bacilli could be detected. Upon antifungal
       treatment the patient's condition improved, but fever spells and high
       inflammatory blood parameters persisted. One year after the diagnosis of
       AML was established, Mycobacterium avium was cultured from bone marrow
       aspirates. The patient's cellular immunity was severely compromised at
       that time as reflected by the marked depression of T-lymphocyte counts,
       in particular of CD4-positive cells. HIV and other lymphotropic virus
       infections were subsequently excluded. After 5 months of specific
       treatment the patient recovered from mycobacterial infection and remains
       in first remission of AML. Opportunistic infections have rarely been
       diagnosed in oncologic patients to date, while data on T-cell function
       in AML is sparse. Fever of unknown origin should prompt the search for
       infectious agents unusual to date in this patient group.
 DE    Adolescence  Case Report  Female  Human  Leukemia, Myelomonocytic,
       Acute/*COMPLICATIONS/DRUG THERAPY  Mycobacterium avium-intracellulare
       Infection/*COMPLICATIONS/  MICROBIOLOGY  JOURNAL ARTICLE

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