Mycobacterial, atypical

• In children, the most common presentation of atypical mycobacterial infection is cervical lymphadenitis
• less commonly, skin and soft tissue infection occur following direct inoculation.
• Disseminated infection in an immunocompetent host is very infrequent, but it has been reported in children younger than 3 years of age
• in the immunocompromised host, atypical mycobacterial infections, especially those caused by Mycobacteria avium complex, are associated with a wide range of signs and symptoms, including:
  • persistent fever (with or without night sweats)
  • weight loss
  • chronic diarrhea
  • abdominal pain
  • extrahepatic obstruction
  • severe anemia.
• In most children, the reaction to a skin test with purified protein derivative (PPD) is weakly positive (5 to 9 mm of induration).
• In the southeastern United States, where atypical mycobacteria are endemic, a "weakly" positive PPD result is more likely to indicate nontuberculous infection than tuberculous infection.
   

American Academy of Pediatrics. Diseases caused by nontuberculous
mycobacteria. In: Pickering LK, ed. 2000 Red Book: Report of the
Committee on Infectious Diseases. 25th ed. Elk Grove Village, Ill:
American Academy of Pediatrics; 2000:613-618