Mycobacteriumabscessus-associated vertebral osteomyelitis in an immunocompetent patient: a rare case report and literature review

Introduction Vertebral osteomyelitis (VO) is an uncommon infection with Staphylococcus aureus as the most commonly implicated organism. VO caused by nontuberculous mycobacteria (NTM) such as Mycobacterium abscessus ( M . abscesscus) is exceedingly rare with only eight cases reported in literature. C...

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Bibliographic Details
Published in:Spinal cord series and cases 2019-05, Vol.5 (1), p.53-53
Main Authors: Moral, Muhammad Z., Desai, Khusboo, Arain, Abdul R., O’Leary, Robert E., Haddad, Stefanos F., Lawrence, James P.
Format: Article
Language:English
Subjects:
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Anatomy
Antibiotics
Biomedical and Life Sciences
Biomedicine
Biopsy
Bone surgery
Case Report
Case reports
Fractures
Human Physiology
Immunocompetence
Infections
Infectious diseases
Literature reviews
Neurochemistry
Neuropsychology
Neurosciences
Pain
Spinal cord
Trauma
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Summary:Introduction Vertebral osteomyelitis (VO) is an uncommon infection with Staphylococcus aureus as the most commonly implicated organism. VO caused by nontuberculous mycobacteria (NTM) such as Mycobacterium abscessus ( M . abscesscus) is exceedingly rare with only eight cases reported in literature. Case presentation We report a rare case of an 82-year-old male with a remote history of trauma who was diagnosed with NTM vertebral osteomyelitis. The patient initially underwent a vertebroplasty of T12 and kyphoplasty of L1 for pathologic compression fractures. Subsequent cultures revealed M . abscess us. The patient further underwent an anterior T12-L2 corpectomy and debridement with instrumented fusion, as well as a posterior T9-L4 instrumentation and fusion. He received multi-agent antibiotic therapy; however, was ultimately unable to tolerate the aggressive treatment regimen and his prolonged postoperative course. Discussion Nontuberculous mycobacteria vertebral osteomyelitis is exceedingly rare. NTM vertebral osteomyelitis is challenging to treat. Surgical management plays a limited role in early VO, but is the mainstay treatment in chronic VO. Early recognition of the condition and shared patient management with multidisciplinary teams is key to successfully treating cases of NTM VO.
ISSN:2058-6124
DOI:10.1038/s41394-019-0197-5