Atypical mycobacterial infections in children with cancer

Atypical mycobacteria are seen more frequently as a cause of serious infection in children with cancer. Thirteen pediatric cancer patients with blood or tissue cultures positive for atypical mycobacteria were identified by review of records over a 5-year period at one center. All had central venous catheters and were lymphopenic at the time of infection. Eleven children had rapidly growing mycobacteria and two children had M. avium-intracellulare. Nine patients had positive blood cultures. Three were treated with catheter removal as sole therapy, five had catheter removal plus antibiotics, and one had antibiotics alone. Two patients with pulmonary M. avium-intracellulare infection received antibiotic therapy alone. It is concluded that infection with rapidly growing mycobacteria in children with cancer is associated with presence of a central venous catheter and lymphopenia. Some children with uncomplicated catheter-associated infection with rapidly growing mycobacteria may be sufficiently treated with removal of the catheter alone.