Mycobacterium abscessus Complex Osteomyelitis of the Wrist

Area of Science:

• Infectious Diseases
• Bacteriology
• Skeletal Infections

Background:

• Mycobacterium abscessus is a rapidly growing non-tuberculous mycobacterium.
• It can cause severe infections, particularly in immunocompromised individuals.
• Contaminated injectable products are a known source of infection.

Observation:

• A 28-year-old patient with a history of intravenous drug use developed osteomyelitis of the right wrist.
• The infection occurred after surgical repair of a right radial artery pseudoaneurysm.
• Surgical debridement of the distal radius infection was performed.

Findings:

• Histopathological examination and tissue cultures confirmed Mycobacterium abscessus complex infection.
• The patient received a six-week course of intravenous amikacin, azithromycin, and cefoxitin.
• Long-term oral treatment included linezolid and clofazimine for six months.

Implications:

• This case highlights Mycobacterium abscessus as a potential pathogen in osteomyelitis, especially in individuals with risk factors like intravenous drug use.
• Effective treatment requires a multi-modal approach involving surgical debridement and prolonged antibiotic therapy.
• Early diagnosis and appropriate management are crucial for favorable outcomes in challenging mycobacterial bone infections.