Chronic granulomatous disease of childhood and Chromobacterium violaceum infections in the southeastern United States.

Patients with chronic granulomatous disease are predisposed to infections by catalase-positive organisms in the environment. Chromobacterium violaceum is a catalase-positive bacterium whose saprophytic source in this country is the subtropical soil and water of the southeastern United States. Two patients with chronic granulomatous disease, followed at the National Institutes of Health in Maryland, acquired C. violaceum infections in Florida. All 10 cases previously reported were acquired in Florida and Louisiana, and reports for which dates were available showed that all infections were acquired from June to September. Seven of 10 patients died; one patient was studied and found to have chronic granulomatous disease. Thus, at least three of the 12 known patients have had underlying chronic granulomatous disease. We suggest that C. violaceum infections occur with unusual frequency in patients with a common underlying predisposing disorder; C. violaceum poses a potential threat to patients with chronic granulomatous disease living in or visiting the endemic states.