Vertebral osteomyelitis caused by non-tuberculous mycobacteria

Petitjean, G.; Fluckiger, Ursula; Schären, Stefan; Laifer, Gerd

doi:10.1111/j.1469-0691.2004.00949.x

Cited by 70 publications

(58 citation statements)

References 19 publications

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“…It is the most common cause of systemic infection in persons with acquired immune deficiency syndrome (AIDS) or immunosuppression 17) . Although infections by Mycobacterium intracellulare are reported in lung, lymph nodes, skin and soft tissues, spine infections are very rare 11) . A MedLine review of literature for spine infections by Mycobacterium intracellulare between 1965 and 2011 revealed only about 30 case reports and there are no reports regarding post-operative spondylitis by Mycobacterium intracellulare.…”

Section: Resultsmentioning

confidence: 99%

“…However, there are only few reports of post-operative spondylitis by non-tuberculous mycobacterium (NTM). In patients with spondylitis, the degree of immunosuppression is as high as 51.5% 11) . However, there are no consensus treatment guidelines for the treatment of spondylitis 11) .…”

Section: Introductionmentioning

confidence: 99%

“…However, there are no consensus treatment guidelines for the treatment of spondylitis 11) . In a case, due to multi-drug resistance, prolonged anti-mycobacterial medications in combination with radical debridement with or without fusion are essential for spondylitis by NTM 5)…”

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confidence: 99%

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An Unusual Case of Post-Operative Spondylitis Caused byMycobacterium Intracellularein an Immunosuppressed Patient

Kim

Son

Lee

et al. 2011

J Korean Neurosurg Soc

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A 75-year-old female with low back pain and paraparesis after a fall presented to our hospital for evaluation. On the neurologic examination, motor function in both legs were decreased to a grade of 3/5 and severe low back pain was associated with localized tenderness over the lumbar region. She had received medications of steroids for rheumatoid arthritis for 2 years. No previous surgeries had been performed except for removal of fibromyoma in both wrists. Laboratory testing showed that the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white cell count were normal. The radiologic examination revealed osteoporotic compression fractures of L1, L3 and L4 bodies and an epidural hematoma compressing the spinal cord along the dura mater of the L2 to L4 spine ( Fig. 1, 2). She underwent urgent decompressive laminectomies of L2, L3 and L4 and removal of the dark-red epidural mass with multiple tissue cultures. She was treated with cefazolin for prevention of postoperative infection and the steroids for rheumatoid arthritis were discontinued. She was symptom-free after surgery and ambulated well with braces. The histopathologic results showed that the stains of the biopsy specimens were all negative for bacteria, fungi and acid-fast bacilli (AFB). Ten days post-operatively, even though the ESR and CRP were elevated to 50 mm/hr INTRODUCTION Post-operative spondylitis is an undesirable complication of spinal surgery. Staphylococcus aureus has been reported as the most frequently isolated organism in patients with post-operative spondylitis 8) . Recently, infections with methicillin-resistant S. aureus (MRSA) and gram-negative organisms have increased dramatically 14) . However, there are only few reports of post-operative spondylitis by non-tuberculous mycobacterium (NTM). In patients with spondylitis, the degree of immunosuppression is as high as 51.5% 11). However, there are no consensus treatment guidelines for the treatment of spondylitis 11) . In a case, due to multi-drug resistance, prolonged anti-mycobacterial medications in combination with radical debridement with or without fusion are essential for spondylitis by NTM 5). We report an unusual case of post-operative spondylitis by Mycobacterium intracellulare in a immunosuppressed patient. Department of Neurosurgery, School of Medicine, Pusan National University, Yangsan Hospital, Yangsan, KoreaThere are few reported cases of post-operative spondylitis caused by Mycobacterium intracellulare. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were posi...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Unusual Case of Post-Operative Spondylitis Caused byMycobacterium Intracellularein an Immunosuppressed Patient

Kim

Son

Lee

et al. 2011

J Korean Neurosurg Soc

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“…Further, vertebral osteomyelitis caused by Mycobacteria other than M. tuberculosis and Brucellosis may also mimic Pott's disease [27][28][29].…”

Section: Diagnostic Imaging Sectionmentioning

confidence: 99%

A large tuberculosis abscess causing spinal cord compression of the cervico-thoracic region in a young child

et al. 2013

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Introduction Despite numerous descriptive publications, the guidelines for treatment of cervical spinal tuberculosis (TB) are not very clear. The authors report a case of a young girl with cervico-thoracic spinal TB extending from C5 to T3 vertebrae presenting with weakness of the right hand and unsteady gait. Case report An 11-year-old female who is an immigrant to the UK from Afghanistan, presented to our clinic with a 10-day history of difficulty in walking with an unsteady gait and 3-month history of progressive weakness in both her arms, the right side more affected than the left. Her immunisation history was unclear. Examination of the arms showed bilateral thenar and hypothenar wasting, more so on the right than the left. An MRI scan revealed a large para-spinal abscess extending from C3/4 to T4/5 with a significant anterior epidural cord compression from C5/6 to

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“…Considering that the maximum diagnostic yield is obtained when the sample is processed microbiologically and pathologically [10,12,34,40], it is advisable whenever possible to obtain two samples, one for microbiological study and the second to send to the pathology laboratory. Since the presence of granulomas is not pathognomonic of tuberculosis [41], when it is only possible to take one sample and this cannot be divided or the sample is from an abscess, priority should always be given to the microbiological study. In the case of paravertebral or psoas abscess, CT-guided aspiration not only helps in the diagnosis but also avoids surgical drainage in a high percentage of cases [42].…”

Section: Vertebral Biopsymentioning

confidence: 99%