An Unusual Acid-Fast Bacillus Causing Systemic Disease and Death in a Child With Special Reference to Disseminated Osteomyelitis and Intracellular Parasitism

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Abstract
An unusual acid-fast bacillus that has been studied in various centers. The partly controversial findings would indicate that it might be classified as Mycobacterium resembling in many respects Mycobacterium tuberculosis var. avium and with some characteristics of Nocardia intracellularis. The bacteriologic, serologic, and pathogenic findings are presented. This microorganism is considered as the cause of disease and death in a 2-year-old Negro child. History, biopsy, and autopsy findings are reported. Distinguishing features are the extensive involvement of bones and lungs and the preference for intracellular parasitism. These characteristics are discussed; they are considered rare findings that are to a certain extent typical for mycobacteria. It is stressed that unusual acid-fast bacilli are potentially dangerous and that the presence of intracellular acid-fast bacilli in skin ulcers does not justify a diagnosis of leprosy.