Disseminated Mycobacteriosis Caused by Battey Type Mycobacteria

Abstract

A 62 year old white female who died with disseminated mycobacteriosis caused by a Battey type mycobacterium is described. Her 13 month illness was characterized by weight loss, skin rash, fever, anemia, intermittent thrombocytopenia, a leukemoid reaction, hypergamma-globulinemia, hepatosplenomegaly, and a disseminated pulmonary infiltrate. The literature on disseminated Battey bacillus infections has been reviewed. Eight cases have been reported previously: five in infants, one in a 13 year old, and two in adults. Anemia, leukocytosis, hypergammaglobulinemia, and hepatosplenomegaly are frequent features of this disease. Many of the infants presented with osteolytic bone lesions and lymphadenopathy suggesting the diagnosis of one of the reticuloendothelloses. While no specific defect in host defense mechanisms was obvious in any of these patients, it is of interest that the patient reported appeared to have disseminated histoplasmosis, another adult patient was found to have associated cryptococcosis at autopsy, a third adult was felt to have chronic myelongenous leukemia, and one of the infants had repeated viral respiratory infections. Antituberculous therapy had little effect on the course of the disease and all of the cases have terminated fatally.