ABSTRACT
Two children of the same family were admitted to the pediatric ward with a history of productive cough, nocturnal sweats, and weight loss. On physical examination, lymphadenopathy was seen on both sides of the neck and axillae. The sizes of the lymph nodes varied, and some showed fistula formation with drainage. A chest x-ray of the boy revealed diffuse nodular densities, while in the girl, peribronchial thickening in both lower lung zones and hilar adenopathy were detected. Sonography of the abdomen and pelvis in both cases showed multiple para-aortic adenopathies with hypodense centers. Microscopic examination of sputum, gastric washings, and node biopsy specimens proved positive for acid-fast bacilli. Systematic identification of acid-fast bacilli on Lowenstein-Jensen culture media identified the isolates as Mycobacterium gastri. These appear to be the first cases of pediatric infection and the fourth report of human infection caused by this atypical Mycobacterium.
