[A case of spinal osteomyelitis due to Mycobacterium intracellulare with pulmonary Mycobacterium avium complex]

A 76-year-old woman was admitted to our hospital in October 2007 because of fever and anorexia. Chest computed tomography demonstrated consolidation and reticular shadows in the right middle lobe and left lingula. Pulmonary nontuberculous mycobacteriosis was diagnosed based on isolation of Mycobacterium intracellulare from her sputum. Her symptoms, which included fever, were improved by chemotherapy with clarithromycin and ethambutol, but the treatment was halted due to adverse effects. Subsequently, she complained of lumbago from April 2008, and spinal osteomyelitis from the T-4 through T-5 vertebral bodies was suspected based on the findings of magnetic resonance imaging. Spinal osteomyelitis due to Mycobacterium intracellulare was diagnosed based on isolation of the bacteria from a tissue culture taken from the vertebral body. Surgery was performed after chemotherapy with clarithromycin, rifampicin and moxifloxacin. Spinal osteomyelitis caused by nontuberculous mycobacterium infection should be considered due to a worldwide increase in reported cases of pulmonary nontuberculous mycobacteriosis.