Mycobacterium mageritense Pulmonary Disease in Patient with Compromised Immune System

that the clinical isolate and the larvae from the Pacifi c cod were identifi ed as P. azarasi, 1 of 2 species found in water near Japan. Adult worms live in the intestines of seals and sea lions, and infective larvae live in the tissues of various marine fi sh, including cod, pollack, and smelt (1). In Japan, most patients infected with Pseudoterranova spp. have acute or subacute abdominal pain, and larvae are extracted from the stomach endoscopically. However, for some patients, diagnosis is made when 4th-stage larvae are expelled from the mouth, indicating that the larvae developed from the 3rd to 4th stage during the time of infection, as did the worm reported here. Expulsion of Pseudoterranova spp. larvae from the mouth in the absence of severe gastric symptoms occurs more commonly in Chile (5). Whether the varied symptoms triggered by infection with Pseudoterranova spp. larvae refl ect different responses of individual hosts to the worms or whether the pathogenicity of Pseudoterranova spp. in humans differs among worm species remains to be elucidated. Because of the increasing worldwide popularity of eating sushi and sashimi made of raw marine fi sh, consumers should be made aware of the possible risk for fi sh-borne parasitoses. Freezing and storing fi sh at −20°C for 7 days or freezing at −35°C until solid and storing at −35°C for 15 hours is suffi cient to kill parasites (6).