Osteomyelitis caused by nontuberculous mycobacteria (NTM) can have severe consequences and a poor prognosis. Physicians therefore need to be alert to this condition, especially in immunocompromised patients. Although the pathogenesis of NTM
osteomyelitis is still unclear, studies in immunodeficient individuals have revealed close relationships between NTM
osteomyelitis and defects associated with the interleukin-12-interferon-γ-tumor
necrosis factor-α axis, as well as human immunodeficiency virus
infection, various immunosuppressive conditions, and
diabetes mellitus. Culture and species identification from tissue biopsies or surgical
debridement tissue play crucial roles in diagnosing NTM
osteomyelitis. Suitable imaging examinations are also important. Adequate surgical
debridement and the choice of appropriate, combined
antibiotics for long-term anti-mycobacterial
chemotherapy, based on in vitro
drug susceptibility tests, are the main
therapies for these bone
infections. Bacillus Calmette-Guerin vaccination might have limited prophylactic value. The use of multiple drugs and long
duration of treatment mean that the therapeutic process needs to be monitored closely to detect potential side effects. Adequate duration of anti-mycobacterial
chemotherapy together with regular monitoring with blood and imaging tests are key factors determining the recovery outcome in patients with NTM
osteomyelitis.