Postoperative osteomyelitis due to mycobacterium fortuitum

Abstract

A rare case of osteomyelitis of the tibia caused by Mycobacterium fortuitum which developed after closed intramedullary Küntscher nail fixation is reported. After extraction of the nail, combination therapy with antituberculous drugs, ofloxacin, and interleukin 2 was undertaken and bony union was achieved. Since a bone cyst formed during union, curettage and conventional cancellous bone grafting were performed. The patient is now pain-free even with prolonged weight-bearing. The success of treatment in this case is in contrast to other reports of the disease.

Mycobacterium Smegmatis Infection of a Lumbar Spine Instrumented Fusion

“…This study suggests that these atypical mycobacterial infections-like their TB counterparts-can be resolved in the face of retained hardware with aggressive medical treatment of these infections (Jain et al, 2007;Chen et al, 2011;Fukuta et al, 2003;Kim et al, 2004;Rappaport et al, 1990;Guven et al, 1994;Swanson et al, 2006)-although other opinions exist (Plaus and Hermann, 1991;Hasegawa et al, 1992).…”

“…This case demonstrates the insidious onset of the infection despite the initial healing post-surgical wound (Pruitt et al, 1993;Hand and Sanford, 1970;Chada et al, 1998;Cobbett, 1918), the lack of response to surgical drainage alone (Widgerow et al, 1995;Smith, 1976;Plaus and Hermann, 1991), the importance of expanding the extent of anatomic imaging studies, the role of interventional CT guided biopsy and drainage (Pruitt et al, 1993;Brown et al, 1999) and the role of antibiotic therapy with multiple antibiotics (Prosser, 1986;Hasegawa et al, 1992). This study suggests that these atypical mycobacterial infections-like their TB counterparts-can be resolved in the face of retained hardware with aggressive medical treatment of these infections (Jain et al, 2007;Chen et al, 2011;Fukuta et al, 2003;Kim et al, 2004;Rappaport et al, 1990;Guven et al, 1994;Swanson et al, 2006)-although other opinions exist (Plaus and Hermann, 1991;Hasegawa et al, 1992).…”

Mycobacterium chelonae and Mycobacterium fortuitum infection following open fracture: A case report and review of the literature

“…[3] There are also case reports of NTM osteomyelitis involving other bones, such as the tibia after intramedullary nailing, [4] the distal femur after arthroscopy, [5] the cuboid after nail puncture wound, [6] and the proximal humerus after open fracture. [7] Immunocompromised patients, such as those on long-term steroids or those infected with HIV, are also at increased risk of developing NTM osteomyelitis.…”

“…[1,2] It has also been sporadically reported in HIV-negative patients in the background of organ transplant and chemotherapy-related immunosuppression, reticuloendothelial malignancies, and corticosteroid therapy. [3][4][5] The spectrum of disease caused by C. neoformans ranges from pulmonary infection to disseminated disease frequently involving the central nervous system, and occasionally skin and bone. Resistance to cryptococcosis depends primarily on cell-mediated immunity.…”

Mycobacterium fortuitumInfection Following Primary Achilles Tendon Debridement with Flexor Hallucis Longus Augmentation: A Case Report

“…We report the case of a patient whose surgery was complicated by infection due to M. fortuitum , a non-tuberculous mycobacterium known to cause infectious complications of surgical wounds of general, dermatologic, trauma, hand and plastic surgery procedures. 5-8,10,11 The presentation of infection with this organism is atypical and failure to consider the pathogen and take the appropriate cultures may result in delayed diagnosis and increased morbidity. We present an unusual case of a M. fortuitum infection following an Achilles tendon surgery in a non-immunocompromised host.…”