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Pin tract infection caused by Mycobacterium neoaurum in a 14-year-old child: A case report
Taizo Kusano1, Chie Fukasawa1, Shota Yamamoto1
1Chiba Children's Hospital, Division of Infectious Diseases, Chiba, Japan.
Abstract:
Although rapidly growing non-tuberculosis mycobacterium can occasionally cause postoperative infections, Mycobacterium neoaurum is a rare pathogen of surgical site infection. We report a case of pin tract infection caused by M. neoaurum in a 14-year-old girl who was admitted for lengthening of her right fourth metatarsal bone. Pain, redness, and exudate were observed 18 days after external fixator insertion. Repeated exudate cultures revealed M. neoaurum, and she was diagnosed with a mycobacterial pin tract infection. She was initially administered intravenous ciprofloxacin and minocycline, and then was switched to oral trimethoprim-sulfamethoxazole and minocycline for a total of 6 months. Despite the pin tract infection, bone lengthening was completed under antibiotic treatment without removal of the pin; no other complications were noted. There are no prior reports of external fixator pin tract infection by M. neoaurum. While such cases may be rare, this case demonstrates that bone distraction may still be successfully completed using appropriate antibiotic therapy without pin removal.
Insights
Mycobacterium neoaurum, a rare pathogen, caused a pin tract infection during bone lengthening in a teenage girl. Successful treatment with antibiotics allowed completion of the procedure without pin removal.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Postoperative infections can arise from rapidly growing non-tuberculosis mycobacteria.
- Mycobacterium neoaurum is an infrequently identified cause of surgical site infections.
Observation:
- A 14-year-old girl developed a pin tract infection 18 days after external fixator insertion for metatarsal bone lengthening.
- Culture of exudate confirmed Mycobacterium neoaurum as the causative agent.
Findings:
- The patient received a 6-month course of antibiotics, including ciprofloxacin, minocycline, and trimethoprim-sulfamethoxazole.
- Bone lengthening was successfully completed despite the infection, without the need for pin removal.
Implications:
- This case represents the first reported instance of external fixator pin tract infection caused by Mycobacterium neoaurum.
- It suggests that bone distraction can be successfully managed with appropriate antibiotic therapy, even in the presence of rare mycobacterial infections, avoiding hardware removal.
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