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A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients

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Mycobacterium phlei Vertebral Osteomyelitis.

Alan W McGee¹, Chase S Dean¹, Ashley Ignatiuk¹

¹Department of Orthopaedic Surgery (Dr. McGee, Dr. Dean, and Dr. Kleck), The University of Colorado, Aurora, CO; the Division Plastics and Reconstructive (Dr. Ignatiuk), Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ; and the Department of Infectious Diseases (Dr. Savelli), The University of Colorado School of Medicine, Aurora, CO.

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews

|February 20, 2020

Summary

This summary is machine-generated.

This case report details a rare instance of vertebral osteomyelitis caused by Mycobacterium phlei, an uncommon pathogen. Prompt diagnosis and treatment of this nontuberculous mycobacterial infection are crucial for patient recovery.

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Area of Science:

Infectious Diseases
Spinal Surgery
Mycobacteriology

Background:

Vertebral osteomyelitis requires accurate pathogen identification for effective treatment.
Nontuberculous mycobacteria (NTM) infections, including those by Mycobacterium phlei, are rare and diagnostically challenging.
Standard microbiological tests may be insufficient for timely NTM diagnosis.

Observation:

A 45-year-old male presented with chronic back pain and radicular symptoms post-lumbar fusion.
Initial cultures were negative, but spinal fluid acid-fast bacilli later identified Mycobacterium phlei.
The patient had a history of deep infection and incomplete spinal fusion.

Findings:

This is the first reported case of Mycobacterium phlei causing vertebral osteomyelitis.
The diagnosis was delayed due to initially negative cultures and the slow growth of the organism.
A 12-month, four-drug regimen for NTM infection led to successful treatment without recurrence.

Implications:

Highlights the importance of considering uncommon pathogens like Mycobacterium phlei in refractory osteomyelitis.
Underscores the need for advanced diagnostic methods for NTM infections.
Emphasizes the necessity of tailored treatment strategies for NTM vertebral osteomyelitis in the absence of established guidelines.