Rare spondylodiscitis due to Mycobacterium mucogenicum

Nontuberculous mycobacteria (NTM) represents an important cause of infection, particularly in immunocompromised patients. Spondylodiscitis is unusual and may be associated with underlying causes such as drug abuse. Timely diagnosis and treatment are critical, as without this, patients will demonstrate progressive neurological deterioration. Here, we present a rare case of Mycobacterium mucogenicum spondylodiscitis in a 36-year-old male, along with a focused literature review.

A 36-year-old female with previous drug abuse presented with 3-years of progressive thoracolumbar pain. The MRI of the spine revealed paravertebral abscesses from Th10-L1 with vertebral lesions involving Th11-Th12 levels (e.g., vertebral body collapse/deformity and destruction of the posterior vertebral walls). After a needle CT-guided biopsy of the paravertebral tissues, real time-polymerase chain reaction (RT-PCR) amplification documented NTM; the final identification was M. mucogenicum. The patient then underwent a Th11-Th12 decompressive laminectomy, facetectomy, granulomatous tissue debridement, and posterior pedicle screw fusion from Th8-Th10, and L1-L3. Postoperatively, the patient's pain resolved, and she was left with residual lower extremities dysesthesias; 6-months later, she could walk without assistance.

Spondylodiscitis caused by M. mucogenicum is rare, and the medical and surgical treatment is comparable to that for other NTM groups.