Mycobacterium xenopi infection of the spine: a case report and literature review.

Study Design. A case report of Mycobacterium xenopi. Objectives. To present a case report of a vertebral osteomyelitis caused by M. xenopi and to review the world literature on the subject. Summary of Background Data. M. xenopi is most commonly a pulmonary pathogen in immunosuppressed patients or those with underlying lung disease. Infection of the spine is very rare, with only four cases reported. Three of these cases occurred in immunosuppressed patients, and the fourth in a patient with previous tuberculosis osteomyelitis of the spine. Methods. The information was obtained from a review of the patient's clinical notes and follow-up appointments. Results. The patient was a 73-year-old woman with an M. xenopi osteomyelitis of T6-T7, confirmed by magnetic resonance imaging and a computed tomography-guided biopsy. She was treated with surgical decompression and stabilization before a 2-year antibiotic regimen was begun. At follow-up assessment 1 year after the antibiotics were finished, she still had some ongoing back pain, but no evidence of relapse. Conclusions. This is the first reported case of an M. xenopi infection of the spine in a patient with no predisposing factors. This type of infection can be difficult to treat, with a high relapse rate reported despite prolonged courses of antibiotics.