[Atypical mycobacteria. Disseminated infection in patients with hematologic diseases]. / Atypiske mykobakterier. Dissemineret infektion hos hoematologiske patienter.

During the last decade interest in atypical mycobacteria (AM), especially Mycobacterium avium complex (MAC) has been intense, as a large number of AIDS patients develop disseminated infection with MAC. Disseminated infection has also been reported in other immunocompromised patients, but in much fewer cases. Among haematological diseases hairy cell leukemia (HCL) and chronic myelogenous leukemia (CML) seem to predispose to disseminated AM infection. We review 53 cases of disseminated AM infection in haematological patients reported in the literature, 39 with HCL, ten CML, and four other haematological diseases, and a review of possible treatment is given. The prognosis seems to depend on the course of the underlying haematological disease, and we conclude that early diagnosis and treatment of the infection is of great importance. Blood and bone marrow should therefore be cultivated for mycobacteria in such patients with persistent fever of unknown cause, and in cases with negative cultures and elevated serum values of alkaline phosphatase liver biopsy should be considered.

[Disseminated Mycobacterium avium infection in three patients with hematologic diseases]. / Dissemineret Mycobacterium avium-infektion hos tre haematologiske patienter.

We report three cases of disseminated Mycobacterium avium complex infection in immunocompromised haematological patients. We conclude that in haematological patients with longlasting fever of unknown cause Mycobacterium avium complex infection should be considered and the relevant cultures from blood and bone marrow should be done.

[Systemic mastocytosis with eosinophilia]. / Systemisk mastocytose med eosinofili.

A 67-year old female patient presented with marked eosinophilia in the peripheral blood. The patient had asymptomatic systemic mastocytosis which she had probably had for many years. At the time of diagnosis, the eosinophilia had already produced symptoms of cardiac insufficiency. The patient was treated with prednisone and hydroxyurea which reduced the eosinophil count. In spite of treatment cardiac symptoms progressed, the patient developed atrial flutter, and died in pulmonary oedema. The autopsy showed fibrotic changes in the heart as seen in the fibrotic end stage of Löeffler's endomyocardial disease. The possible reasons for eosinophilia in the patient are discussed.

[Subacute thyroiditis in Parvovirus B19 infection]. / Subakut thyreoiditis ved Parvovirus B19-infektion.

In a 32-year-old women with clinical and scintigraphic signs of thyroiditis, serological screening showed positive IgG and IgM titres against Parvovirus B19 (PB19). Subacute thyroiditis has not previously been reported following PB19 infection. The present case suggests that subacute thyroiditis may be caused by PB19 infection. Further screening is necessary to establish whether this infection is more frequently associated with subacute thyroiditis than previously thought.