Mycobacterium avium infections in man

A disseminated infection with Mycobacterium avium, serotype 1, is described in a 63 year old woman with reticulum cell sarcoma. The organism was demonstrated in vivo in lymph nodes, bone marrow, urine and sputum, and at autopsy within an intraocular abscess. Previous reports of human infections with Myco. avium describe cases of chronic, cavitary pulmonary disease, frequently occurring in patients with pneumoconiosis, cervical lymphadenopathy in children, and disseminated infection. Infected birds and mammals, and soil rich in bird droppings appear to constitute natural reservoirs of infection. However, extensive exposure to birds or the carcasses of slaughtered animals has been documented in only a minority of cases. Myco. avium can be reliably identified only by serotyping or by inoculation into chickens, rabbits and guinea pigs. Skin tests with avian purified protein derivative together with standard purified protein derivatives and antigens prepared from other mycobacteria may be helpful in diagnosis prior to isolation and identification of the organism. Although localized infections have apparently been cured by surgical excision, more extensive infections have been reported to be progressive or fatal and have responded poorly to chemotherapy.