Multiple Bone Destruction Secondary to

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Orthopedic Surgery

Background:

• Mycobacterium kansasii infections typically affect immunocompromised individuals, primarily causing pulmonary and disseminated disease.
• Osteopathy is an uncommon manifestation of Mycobacterium kansasii infection.
• This case presents a rare occurrence in an immunocompetent patient.

Purpose of the Study:

• To report a rare case of multiple bone destruction, including spinal involvement, secondary to Mycobacterium kansasii pulmonary disease in an immunocompetent individual.
• To emphasize the diagnostic challenges and clinical presentation of this rare condition.
• To contribute to the understanding of Mycobacterium kansasii osteopathy.

Main Methods:

• Case report presentation with detailed imaging data.
• Diagnostic confirmation through preoperative sputum testing and next-generation sequencing of intraoperative samples.
• Clinical management involving emergency surgery and anti-tuberculosis therapy.

Main Results:

• A 44-year-old immunocompetent Chinese woman presented with extensive bone destruction, particularly of the spine.
• The patient experienced paraplegia, indicating disease progression.
• Mycobacterium kansasii infection was confirmed via microbiological and molecular methods.
• Treatment with anti-tuberculosis therapy led to a positive patient response.

Conclusions:

• Osteopathy secondary to Mycobacterium kansasii infection is exceptionally rare in immunocompetent individuals.
• Early and accurate diagnosis is crucial, despite potential misdiagnosis challenges.
• This case underscores the importance of considering M. kansasii in the differential diagnosis of bone destruction, even in immunocompetent patients.