Spondylodiscitis caused by Mycobacterium xenopi.
The infection with non-tuberculous mycobacterium correlates highly with immunodeficiency. Mycobacterium xenopi (M. xenopi) is most commonly isolated in the respiratory tract, as a cause of endogenous spondylodiscitis it occurs but rarely. Only seven such cases have been reported in literature. In this paper, we present the case of an about 28-year-old HIV-positive patient with a long history of back pain. MRI of the spinal column and Positron Emission Tomography with (18)F-fluorodeoxyglucose as a tracer (F18-FDG-PET) confirmed the suspected spondylodiscitis. After performing a CT-controlled abscess drainage the patient's condition improved. Because of the severe destruction of the spinal segment concerned and because of the epidural abscess formation a vertebrectomy of T10 and surgical debridement of the paravertebral soft tissue via thoracotomy became urgently necessary. The spine was stabilized by interposing a cage and an anterolateral monobar system. M. xenopi could be proven by PCR out of the intraoperative specimen. After operation and antituberculotic therapy there was a fast convalescence. Diagnostics, therapy, and clinical outcome are discussed.
Sobottke
R
R
Department of Orthopaedic Surgery, University of Cologne, Cologne, Germany. sobottke@gmx.de
Zarghooni
K
K
Seifert
H
H
Faetkenheuer
G
G
Koriller
M
M
Michael
J-W P
JW
Delank
K-S
KS
Eysel
P
P
D000328:Adult; D015299:Discitis / Q000276:immunology / Q000382:microbiology* / Q000628:therapy; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000276:immunology / Q000382:microbiology*; D019912:Mycobacterium xenopi