Generalized fatal chronic infection by Mycobacterium scrofulaceum with severe amyloidosis in a child

The case history and autopsy of a young boy chronically infected with M. scrofulaceum is reported. The pathology of the lesions, which affected mainly the skin and the bones, was that of a nonspecific inflammatory reaction, with many acid-fast bacteria. Some improvement was obtained by these use of several antimycobacterial drugs, but the general condition deteriorated, the child dying at the age of 16 after more than five years of sickness. One of the causes of death was a severe generalized amyloidosis. This case is discussed in relation with the very small number of autopsies of patients dying of infection caused by scotochromogenic mycobacteria, or M. scrofulaceum. A possible immunological defect cannot be entirely ruled out.