Chronic multifocal Mycobacterium fortuitum osteomyelitis following penetrating plantar trauma.
We present the case of a 10-year-old girl with Mycobacterium fortuitum osteomyelitis following a plantar puncture wound with vegetative material. Nontuberculous mycobacterial (NTM) skin and soft tissue infections are well described in immunocompromised populations. However, NTM infection can also be seen in healthy hosts following direct inoculation. Magnetic resonance imaging examination demonstrated multifocal midfoot and metatarsal osteomyelitis. Surgical exploration revealed caseation necrosis and a chronic draining sinus tract. Combined surgical debridement and medical therapy resulted in clinical cure. A high index of suspicion and adequate collection and handling of surgical specimens facilitate the diagnosis and treatment of NTM skin and soft tissue infections.
Baylor College of Medicine, Department of Pediatrics, Section of Emergency Medicine & Infectious Diseases, Houston, Texas 77030, USA. acruz@bcm.edu
Andrea T
AT
Cruz
Shannon B
SB
Antekeier
D002648:Child; D005260:Female; D018409:Foot Injuries / Q000150:complications*; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D019907:Mycobacterium fortuitum / Q000302:isolation & purification*; D010019:Osteomyelitis / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology* / Q000601:surgery; D014950:Wounds, Penetrating / Q000150:complications*