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M. chelonae soft tissue infection spreading to osteomyelitis
Ryuh Sup Kim1, Jun Sik Kim, Dong Hoon Choi
1Department of Orthopedic Surgery, Inha University Hospital, Inchon, Korea. keelim@inha.ac.kr
Yonsei Medical Journal
|March 9, 2004
Summary
A rare Mycobacterium chelonae infection caused a 54-year-old woman's leg soft tissue infection and osteomyelitis. Successful treatment was achieved with a 6-month chemotherapy course, avoiding surgery.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Mycobacterium chelonae is an atypical mycobacteria known for causing infections in immunocompromised individuals.
- Soft tissue infections and osteomyelitis require prompt diagnosis and treatment to prevent complications.
- Delayed diagnosis can lead to disease progression and more complex management.
Observation:
- A previously healthy 54-year-old woman presented with a 8-month history of left lower leg infection.
- The infection originated from soft tissue near the distal femur and progressed to involve the bone (osteomyelitis).
- Initial presentation had unremarkable clinical signs, leading to a low index of suspicion and diagnostic challenges.
Findings:
- The patient was diagnosed with Mycobacterium chelonae soft tissue infection and osteomyelitis.
- Diagnostic difficulties were attributed to indolent presentation, immunocompetent status, and initial inadequate microbiological and histopathological findings.
- The infection was successfully treated with a 6-month course of chemotherapy without surgical intervention.
Implications:
- This case highlights the importance of considering atypical mycobacterial infections even in immunocompetent patients.
- Early and accurate diagnosis is crucial for effective management of Mycobacterium chelonae infections.
- Non-surgical management with chemotherapy can be a viable option for treating soft tissue and bone infections caused by this pathogen.