Mycobacterium abscessus infections rarely develop in healthy individuals, and mostly they occur in immunocompromised hosts. Vertebral
osteomyelitis due to Mycobacterium abscessus is very rare and only three previous cases of spinal
infection caused by Mycobacterium abscessus have been reported. Mycobacterium abscessus isolates are uniformly resistant to antituberculous agents and can display a virulent biofilm-forming phenotype. The patient was a 67-year-old woman with vertebral
osteomyelitis of the L1-2. She was healthy without immune-suppressed condition, history of
trauma, or intravenous
drug use. The smear examination of the specimen harvested by CT-guided
puncture of the paravertebral
abscess revealed Mycobacterium abscessus.
Her disease condition did not abate with
conservative treatment using antimicrobial
chemotherapy. Radical
debridement of the vertebral
osteomyelitis and anterior reconstruction from T12 to L2 using antibacterial
iodine-supported instrumentation were performed.
Chemotherapy using
clarithromycin,
amikacin, and
imipenem was applied for 6 months after surgery as these
antibiotics had been proven to be effective to Mycobacterium abscessus after surgery. Two years after surgery, the infected anterior site healed and bony fusion was successfully achieved without a recurrence of
infection.