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Septic Nonunion Caused by Mycobacterium canariasense: A Case Report
Matias Vicente1, Mayli Lung, Carlos Gulin
1Orthopedic Department (M.V.), Septic and Reconstructive Surgery Unit (P.S.C.), and Microbiology Department (M.L., C.G., and M.T.T.), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
JBJS Case Connector
|November 16, 2018
Summary
A rare Mycobacterium canariasense infection caused a humeral shaft nonunion in a former drug user. Despite no antibiotic treatment, the patient achieved solid bone fusion, highlighting atypical pathogen importance.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- A 43-year-old male with a history of drug use presented with a complex humeral shaft fracture.
- The patient had undergone two prior surgeries for Staphylococcus aureus infection, including debridement and osteosynthesis.
Observation:
- Culture of bone specimens revealed Mycobacterium canariasense, an atypical mycobacterial pathogen.
- Diagnosis was confirmed post-discharge, precluding immediate antibiotic therapy.
Findings:
- Despite the lack of targeted antibiotic treatment, the patient demonstrated solid bone fusion at the humeral shaft.
- This case represents the first reported instance of septic nonunion attributed to Mycobacterium canariasense.
Implications:
- Highlights the need to consider unusual pathogens, such as atypical mycobacteria, in refractory bone infections.
- Suggests potential for spontaneous healing or host factors contributing to bone union even in the presence of un treated atypical infections.
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