Pott's disease: a case of <i>Mycobacterium xenopi</i> infection of the spine

Alfreijat, Majd; Ononiwu, Chiagozie; Sexton, Carlton C.

doi:10.3402/jchimp.v2i4.20150

Cited by 6 publications

(5 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A Pub-Med search for “Mycobacterium xenopi” plus “spinal” or “vertebral” in humans, published in English and French through August 2022 resulted in 18 unique cases of M. xenopi spine infections, dating between 1983 and 2022 ( Table 2 ). [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] We found a report with 58 spinal infection cases during an outbreak in a French Sport Clinic, but since there was no clinical data describing the cases, we did not include that paper in the review of cases. [24] .…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium xenopi native vertebral osteomyelitis and discitis: Case & review of published cases

Bekina-Sreenivasan

Saleeb

Schmalzle

2023

IDCases

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Mycobacterium xenopi native vertebral osteomyelitis and discitis: Case & review of published cases

Bekina-Sreenivasan

Saleeb

Schmalzle

2023

IDCases

View full text Add to dashboard Cite

“…Therefore, greater awareness of the ATS nontuberculous mycobacteria management guidelines is recommended in the literature, to optimise the clinical response. 17…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent study on mice shows significant bactericidal effect with ethambutol/ rifampicin combination with either clarithromycin or moxifloxacin. 17 We report a case of thoracic spine osteomyelitis caused by M. xenopi, destroying three contiguous midthoracic vertebrae, causing spinal stenosis and myelopathy. The patient was successfully treated with anti-TB treatment (ATT), 18 after limited cold abscess drainage.…”

Section: Introductionmentioning

confidence: 99%

Mycobacterium xenopi osteomyelitis of the spine: a case report

2021

SA orthop. j.

View full text Add to dashboard Cite

BACKGROUND: Mycobacterium xenopi (M. xenopi) osteomyelitis is an uncommon infection which is found in immunosuppressed patients. It is reported to be a slow-growing, nonchromogenic or scotochromogenic nontuberculous mycobacterium. The lungs constitute the most common site for infection and extrapulmonary manifestations, and disseminated forms of the disease are rare. Only a few cases of spontaneous spinal involvement have been reported. We report a case of M. xenopi vertebral osteomyelitis of the spine PATIENT AND METHODS: A 41-year-old female patient, HIV reactive on antiretroviral therapy with a low CD4 count of 183 cells/mm3, presented with clinical and radiological features in keeping with thoracic spinal tuberculosis, complicated with thoracic myelopathy. She was managed surgically with costo-transversectomy and drainage of the paraspinal cold abscess. The Ziehl-Neelsen staining was negative for acid-fast bacilli. However, the histology result revealed a necrotising granulomatous inflammation. A delayed result of polymerase chain reaction (PCR)/line probe assay for Mycobacterium genus testing revealed the presence of M. xenopi, as the cause for the spine osteomyelitis and thoracic myelopathy. However, no M. xenopi susceptibility testing, and no specific photoreactivity techniques for strain identification, were performed. Anti-tuberculosis therapy (ATT) consisting of a two-month initiation phase using rifampicin, isoniazid, ethambutol and pyrazinamide, followed by a seven-month continuation phase using rifampicin and isoniazid, was initiated according to national guidelines. She was fitted with a thoraco-lumbar-sacral orthosis, and underwent a spinal rehabilitation programme. Upon receipt of the PCR result, and considering the good clinical and radiological response to ATT, a consensus was reached with the Infectious Disease Unit (IDU) to continue with ATT until 18 months due to the atypical nature of the pathogen. RESULTS: The patient was successfully treated with the standard TB regimen, but for a period of 18 months, and made full clinical neurological recovery, without any back pain. Furthermore, her CD4 count had also improved to 707 cells/mm3 with a viral load reported lower than 1 000 copies/ml CONCLUSION: This case report emphasises the importance of biopsy in suspected spinal tuberculosis and highlights the concerns with laboratory testing and the prognostic and therapeutic implications of a positive strain identification Level of evidence: Level 5 Keywords: Mycobacterium xenopi osteomyelitis, tuberculosis, anti-tuberculosis treatment

show abstract

“…The discussion mentions Dr. Percivall Pott and his cohort, Dr. James Paget. Also, looking at imaging of remains from a previous millennium shows that tuberculosis was endemic in the Americas long before it was in Europe (7). …”

mentioning

confidence: 99%

“…A paper on internal medicine recertification practices and implications for care is the first paper on a CME topic in the two-year history of JCHIMP (12). In addition, there are three case reports: thrombotic thrombocytopenic purpura (TTP) following a medical procedure (13); asymptomatic severe complete heart block in an elderly patient (ECG images) (14); and an old disease (POTTS) in a modern setting with comparisons to similar cases from antiquity secondary to an organism originally detected in an African frog (7). …”

mentioning

confidence: 99%