Rare spondylodiscitis due to Mycobacterium mucogenicum

Abstract

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

Successful management of cervical tuberculosis and severe kyphosis using polyetheretherketone expandable cage and titanium plate: A case report

“…Despite concerns regarding subsidence and implant stability, the patient maintained good spinal alignment and mobility postoperatively. This outcome suggests that, in carefully selected cases, anterior plating with PEEK cages can provide sufficient stability for multi‐level cervical spine reconstruction, even in the presence of infection 18–20 …”

“…This outcome suggests that, in carefully selected cases, anterior plating with PEEK cages can provide sufficient stability for multi-level cervical spine reconstruction, even in the presence of infection. [18][19][20]…”

Thoracic spinal extradural arachnoid cyst: A case report and literature review

“…[ 4 , 8 ] Diagnostic neuroimaging should typically include both CT and MRI studies to differentiate these lesions from cystic tumors (e.g., cystic meningioma) and/or rare spinal infections. [ 3 , 7 ] The treatment most often involves surgical decompression with obliteration of the communication between the subarachnoid space and the extradural cyst followed by cyst resection.…”