Disseminated nongranulomatous Mycobacterium avium osteomyelitis

A 17 month old black girl had multiple, rapidly progressive osteolytic lesions, cervical lymphadenopathy, fever, and weight loss clinically compatible with disseminated malignant disease. Histologically the bone lesions were characteristic of acute nongranulomatous osteomyelitis with a few acid fast organisms. Mycobacterium avium was cultured. Immunologic evaluation showed an intact response to the infection. Disseminated Mycobacterium avium infection may occur in immunologically intact children, clinically simulate malignant disease, and produce an acute nonspecific inflammatory lesion.