A Case of Vertebral Osteomyelitis With Epidural Abscess Caused by Mycobacterium intracellulare in a Rheumatoid Arthritis Patient.
10.4235/jkgs.2013.17.3.138
- Author:
Hae Su KIM
1
;
Jieun KIM
;
Jeong Im CHOI
;
Hye Jin YOON
;
Jae Ha KIM
;
You Shin KIM
;
Dong Shin KWAK
;
Jung Kyu LEE
;
Seunghun LEE
;
Hyunjoo PAI
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. paihj@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Mycobacterium intracellulare;
Nontuberculous mycobacteria;
Osteomyelitis
- MeSH:
Abscess;
Amikacin;
Arthritis, Rheumatoid;
Ciprofloxacin;
Clarithromycin;
Epidural Abscess;
Ethambutol;
Humans;
Immunosuppressive Agents;
Lung Diseases;
Mycobacterium;
Mycobacterium avium Complex;
Nontuberculous Mycobacteria;
Osteomyelitis;
Rifabutin
- From:Journal of the Korean Geriatrics Society
2013;17(3):138-142
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung diseases, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in a rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with antituberculous drugs. Fifty-six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were altered to clarithromycin, rifabutin, and ethambutol. After 3 months of M. intracellulare treatment, the radiological findings showed increases of epidural abscess. According to the suseptibility, the patient received intravenous amikacin for four weeks, and then, oral ciprofloxacin in addition to clarithromycin, rifabutin, and ethambutol. The patient is being treated with the medication for 13 months and currently showing slow improvements.
