T9-T10 Osteomyelitis, Epidural Abscess and Cord Compression Secondary to Mycobacterium abscessus: A Case Report

We report a case of spinal abscess/osteomyelitis at the T9-T10 levels in a non-immunocompromised patient who presented with lower extremity weakness secondary to a Mycobacterium abscessus infection. This patient was successfully treated with surgical debridement with amikacin-tigecycline-imipenem triple therapy before and after her debridement. Outcomes and treatment with this rare cause of epidural abscess/osteomyelitis are not well defined at this time.

Clinical Presentations with this species of mycobacterium are usually systemic with patients presenting with pulmonary and soft tissue infections. The primary presentation of spinal epidural abscess/osteomyelitis is unusual, especially when there is no primary focus such as a lung infection or concurrent bacteremia.

This paper presents a new case of spinal osteomyelitis without a primary source in addition to 10 previously reported M. abscessus cases. The treatment plans and outcomes suggest that surgical debridement along with a macrolide-based combination therapy should be considered a definitive treatment against Mycobacterium abscesses.