title: Mycobacterium kansasii infection of the spine in a patient with sarcoidosis: a case report and literature review.
abstract: Mycobacterium kansasii is an acid-fast bacillus most commonly associated with pulmonary pathology. Infection of the spine is exceedingly rare, with just three reported cases, two of which were in human immunodeficiency virus and acquired immunodeficiency syndrome patients. This case report presents a case of vertebral osteomyelitis secondary to M. kansasii infection and reviews existing literature on this pathogen. The patient, a 37-year-old male with sarcoidosis, sustained a M. kansasii infection of the spine, resulting in vertebral osteomyelitis of L1 and L2 and discitis of the L1-L2 disc. This finding was confirmed by bone and intervertebral disc biopsy. Initially, the patient was thought to have a compression fracture of L2. However, the decision to perform a biopsy was made because of the patient's persistent febrile episodes and magnetic resonance imaging findings. The patient did not have any neurological deficits. He was successfully treated with antimicrobials, with no recurrent symptoms at 2-year follow-up. This case is the first reported case of a M. kansasii infection of the spine in a patient with sarcoidosis.
authors.affiliation: Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Wajeeh R
authors.initials: WR
authors.lastname: Bakhsh
authors.forename: Addisu
authors.initials: A
authors.lastname: Mesfin
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D015299:Discitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005334:Fever / Q000209:etiology; D050815:Fractures, Compression / Q000175:diagnosis; D006801:Humans; D016867:Immunocompromised Host; D007538:Isoniazid / Q000627:therapeutic use; D008159:Lumbar Vertebrae / Q000382:microbiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy; D019909:Mycobacterium kansasii; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D012507:Sarcoidosis / Q000150:complications*; D016103:Spinal Fractures / Q000175:diagnosis
chemical_list: D000995:Antitubercular Agents; D004977:Ethambutol; D007538:Isoniazid