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Mycobacterium abscessus-associated vertebral osteomyelitis in an immunocompetent patient: a rare case report and literature review.
Spinal Cord Series and Cases ( IF 0.7 ) Pub Date : 2019-05-31 , DOI: 10.1038/s41394-019-0197-5 Muhammad Z Moral 1 , Khusboo Desai 1 , Abdul R Arain 1 , Robert E O'Leary 1 , Stefanos F Haddad 1 , James P Lawrence 1
Spinal Cord Series and Cases ( IF 0.7 ) Pub Date : 2019-05-31 , DOI: 10.1038/s41394-019-0197-5 Muhammad Z Moral 1 , Khusboo Desai 1 , Abdul R Arain 1 , Robert E O'Leary 1 , Stefanos F Haddad 1 , James P Lawrence 1
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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. abscessus. 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.
中文翻译：
免疫功能正常患者的脓肿分枝杆菌相关椎体骨髓炎：罕见病例报告和文献综述。
简介 椎体骨髓炎 (VO) 是一种罕见的感染，最常见的感染微生物是金黄色葡萄球菌。由非结核分枝杆菌 (NTM) 如脓肿分枝杆菌 (M.脓肿) 引起的 VO 极为罕见，文献中仅报道了 8 例。病例介绍 我们报告一例罕见病例，患者为一名 82 岁男性，有远古外伤史，被诊断患有 NTM 椎体骨髓炎。该患者最初因病理性压缩骨折接受了 T12 椎体成形术和 L1 椎体后凸成形术。随后的培养显示脓肿分枝杆菌。患者进一步接受了前 T12-L2 椎体切除术和器械融合清创术，以及后 T9-L4 器械融合术。他接受了多药抗生素治疗；然而，他最终无法忍受积极的治疗方案和漫长的术后病程。讨论 非结核分枝杆菌椎体骨髓炎极为罕见。 NTM 椎体骨髓炎的治疗具有挑战性。手术治疗在早期 VO 中发挥的作用有限，但是慢性 VO 的主要治疗方法。及早认识病情并与多学科团队共同管理患者是成功治疗 NTM VO 病例的关键。
更新日期：2019-11-18
中文翻译：
免疫功能正常患者的脓肿分枝杆菌相关椎体骨髓炎：罕见病例报告和文献综述。
简介 椎体骨髓炎 (VO) 是一种罕见的感染，最常见的感染微生物是金黄色葡萄球菌。由非结核分枝杆菌 (NTM) 如脓肿分枝杆菌 (M.脓肿) 引起的 VO 极为罕见，文献中仅报道了 8 例。病例介绍 我们报告一例罕见病例，患者为一名 82 岁男性，有远古外伤史，被诊断患有 NTM 椎体骨髓炎。该患者最初因病理性压缩骨折接受了 T12 椎体成形术和 L1 椎体后凸成形术。随后的培养显示脓肿分枝杆菌。患者进一步接受了前 T12-L2 椎体切除术和器械融合清创术，以及后 T9-L4 器械融合术。他接受了多药抗生素治疗；然而，他最终无法忍受积极的治疗方案和漫长的术后病程。讨论 非结核分枝杆菌椎体骨髓炎极为罕见。 NTM 椎体骨髓炎的治疗具有挑战性。手术治疗在早期 VO 中发挥的作用有限，但是慢性 VO 的主要治疗方法。及早认识病情并与多学科团队共同管理患者是成功治疗 NTM VO 病例的关键。
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