Pulmonal Mycobacterium intracellular infection in hairy-cell leukemia

A case of fatal pulmonal infection with Mycobacterium intracellular in a patient with hairy-cell leukemia is reported. 2 years after diagnosis and splenectomy chronic fever and progressive infiltration of the superior lobe of the left lung developed. Direct microscopical examination of bronchial aspirate detected acid-fast bacilli. Despite vigorous treatment with antituberculosis drugs the patient died shortly after the diagnosis of the infection. The bacteria were post mortem classified as Mycobacterium intracellulare, belonging to Runyon group III. The role of monocytopenia and/or depressed monocyte function in hairy-cell leukemia is discussed.