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Abstract
Isolated bone marrow infection by nontuberculous mycobacteria (NTM) is extremely rare. Recently, we encountered a case of bone marrow Mycobacterium avium complex (MAC) infection, which presented as a fever of unknown origin shortly after starting continuous ambulatory peritoneal dialysis (CAPD). The patient was diagnosed with MAC infection on the basis of PCR-restriction fragment length polymorphism analysis and sequencing of DNA obtained from bone marrow specimens. Although this was a case of severe MAC infection, there was no evidence of infection of other organs. End-stage renal disease (ESRD) patients undergoing dialysis can be considered immunodeficient; therefore, when these patients present with fever of unknown origin, opportunistic infections such as NTM infection should be considered in the differential diagnosis.
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 | Fig. 1.Bone marrow was normocellular and reactive, with histiocytic hemophagocytosis and atypical, non-caseous necrotic regions (hematoxylin and eosin stain, ×400). |
 | Fig. 2.Metaphor agarose gel (4%) electrophoresis of the Msp I-digested PCR product. Lane M, molecular size marker. Lane 1, bone marrow specimen of the patient, showing a protein profile similar to that of Mycobacterium avium (105 bp, 80 bp, 50 bp, and 45 bp). Lane 2, positive control (Mycobacterium tuberculosis; 175 bp, 80 bp, 60 bp, and 40 bp). Lane 3, negative control. |
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