Pulmonary disease caused by rapidly growing mycobacteria in patients with cancer

Five patients with microbiologically documented pulmonary infection caused by rapidly growing mycobacteria (Mycobacterium fortuitum and M chelonei) in patients with malignant diseases are described. These cases occurred over a seven-year period (1976 to 1983) and were found in patients with solid tumors and hematologic malignancies. Colonization (40 patients) with these organisms was far more frequent than true infection (five patients). Factors predisposing to infection were (1) antineoplastic chemotherapy and (2) previous pulmonary involvement with malignant disease. Mortality in these patients was due primarily to the underlying tumor. Although pulmonary infection caused by rapidly growing mycobacteria in patients with cancer is relatively uncommon, it might become an important diagnostic consideration in the presence of pulmonary infiltrates, especially in patients treated with intensive chemotherapeutic regimens.