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Spondylodiscitis caused by Mycobacterium xenopi

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

The infection with non-tuberculous mycobacterium correlates highly with immunodeficiency. Mycobacterium xenopi (M. xenopi) is most commonly isolated in the respiratory tract, as a cause of endogenous spondylodiscitis it occurs but rarely. Only seven such cases have been reported in literature. In this paper, we present the case of an about 28-year-old HIV-positive patient with a long history of back pain. MRI of the spinal column and Positron Emission Tomography with 18F-fluorodeoxyglucose as a tracer (F18-FDG-PET) confirmed the suspected spondylodiscitis. After performing a CT-controlled abscess drainage the patient’s condition improved. Because of the severe destruction of the spinal segment concerned and because of the epidural abscess formation a vertebrectomy of T10 and surgical debridement of the paravertebral soft tissue via thoracotomy became urgently necessary. The spine was stabilized by interposing a cage and an anterolateral monobar system. M. xenopi could be proven by PCR out of the intraoperative specimen. After operation and antituberculotic therapy there was a fast convalescence. Diagnostics, therapy, and clinical outcome are discussed.

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References

  1. Meybeck A, Fortin C, Abgrall S, Adle-Biassette H, Hayem G, Ruimy R, Yeni P (2005) Spondylitis due to Mycobacterium xenopi in a Human Immunodeficiency Virus Type 1-infected patient: case report and review of the literature. J Clin Microbiol 43(3):1465–1466

    Article  PubMed  Google Scholar 

  2. Danesh-Clough T, Theis JC, Linden A (2000) Mycobacterium xenopi infection of the spine. Spine 1;25(5):626–628

    Google Scholar 

  3. Manfredi R, Nanetti A, Morelli S, Ferri M, Valentini R, Calza L, Chiodo F (2004) A decade surveillance study of Mycobacterium xenopi and antimicrobial susceptibility levels in a reference teaching hospital of Northern Italy: HIV-associated versus non-HIV-associated infection. HIV Clin Trials 5(4):206–215

    Article  PubMed  Google Scholar 

  4. Kulasegaram R, Richardson D, Macrae B, Ruiter A (2001) Mycobacterium xenopi osteomyelitis in a patient on highly active antiretroviral therapy (HAART). Int J STD AIDS 12:404–406

    Article  PubMed  CAS  Google Scholar 

  5. Bossert T, Bittner HB, Richter M, Rahmel A, Barten M, Gummert J, Mohr FW (2005) Successful management of two heart transplant recipients with mycobacterial pulmonary infections. Ann Thorac Surg 80(2):719–721

    Article  PubMed  Google Scholar 

  6. Telgt DS, van den Hoogen FH, Meis JF, Lemmens JA, van de Putte LB (1997) Arthritis and spondylodiscitis caused by Mycobacterium xenopi in a patient with systemic lupus erythematosus. Br J Rheumatol 36(9):1025–1026

    Article  PubMed  CAS  Google Scholar 

  7. American Thoracic Society (1997) Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am J Respir Crit Care Med 156:1–25

    Google Scholar 

  8. Schmitt H, Schnitzler N, Riehl J, Adam G, Sieberth HG, Haase G (1999) Successful treatment of pulmonary Mycobacterium xenopi infection in a natural killer cell-deficient patient with Clarithromycin, Rifabutin and Sparfloxacin. Clin Infect Dis 29(1):120–124

    Article  PubMed  CAS  Google Scholar 

  9. Bachmeyer C, Blum L, Stelianides S, Benchaa B, Gruat N, Danne O (2001) Mycobacterium xenopi pulmonary infection in an HIV infected patient under highly active antiretroviral treatment. Thorax 56:978–979

    Article  PubMed  CAS  Google Scholar 

  10. Miller WC, Perkins MD, Richardson WJ, Sexton DJ (1994) Pott’s disease caused by Mycobacterium xenopi: case report and review. Clin Infect Dis 19(6):1024–1028

    PubMed  CAS  Google Scholar 

  11. Ollagnier E, Fresard A, Guglielminotti C, Carricajo A, Mosnier JF, Alexandre C, Lucht F (1998) Osteoarticular Mycobacterium xenopi infection. Presse Med 27(17):800–803

    PubMed  CAS  Google Scholar 

  12. Jones PG, Schrager MA, Zabransky RJ (1995) Pott’s disease caused by Mycobacterium xenopi. Clin Infect Dis 21(5):1352

    PubMed  CAS  Google Scholar 

  13. Astegneau P, Desplaces N, Vincent V, Chicheportiche V, Botherel A, Maugat S, Lebascle K, Leonard P, Desenclos J, Grosset J, Ziza J, Brucker G (2001) Mycobacterium xenopi spinal infections after discovertebral surgery: investigation and screening of a large outbreak. Lancet 1;358(9283):747–751

    Google Scholar 

  14. Kerbiriou L, Ustianowski A, Jonson MA, Gillespie SH, Miller RF, Lipman CI (2003) Human immunodeficiency virus type 1-related pulmonary Mycobacterium xenopi infection: a need to treat? Clin Infect Dis 1;37(9):1250–1254

    Google Scholar 

  15. Schwabacher H (1959) A strain of mycobacterium isolated from skin lesions of a cold blooded animal, Xenopus laevis, and its relation to acid fast bacilli occuring in man. J Hyg 44:378–380

    Google Scholar 

  16. Marks J, Schwabacher H (1965) Infection due to Mycobacterium xenopi. BMJ 1:32–33

    Article  PubMed  CAS  Google Scholar 

  17. Juffermans NP, Verbon A, Danner SA, Kuijper EJ, Speelman P (1998) Mycobacterium xenopi in HIV-infected patients: an emerging pathogen. AIDS 12:1661–1666

    Article  PubMed  CAS  Google Scholar 

  18. El-Helou P, Rachlis A, Fong I (1997) Mycobacterium xenopi infections in patients with human immunodeficiency virus infection. Clin Infect Dis 25:206–210

    Article  PubMed  CAS  Google Scholar 

  19. Prosser AJ (1986) Spinal infection with Mycobacterium xenopi. Tubercle 67:229–232

    Article  PubMed  CAS  Google Scholar 

  20. Rahman MA, Phongsathom V, Hughes T, Bielawska C (1992) Spinal infection by Mycobacterium xenopi in a non-immunosuppressed patient. Tuber Lung Dis 73:392–395

    Article  PubMed  CAS  Google Scholar 

  21. Arasteh KN, Cordes C, Ewers M (2000) HIV related NTM infection: incidence, survival analysis and associated risk factors. Eur J Med Res 5:424–430

    PubMed  CAS  Google Scholar 

  22. Moon M, Woo Y, Lee K, Ha K, Kim S, Sun D (1995) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20:1910–1916

    Article  PubMed  CAS  Google Scholar 

  23. Oga M, Arizono T, Takasita M, Sugioka Y (1993) Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Spine 18:1890–1894

    Article  PubMed  CAS  Google Scholar 

  24. Costrini AM, Manler DA, Gross WM, Hawkins VE, Yesner R, D’Esporo ND (1981) Clinical and roentgenographic features of nosocomial pulmonary disease due to Mycobacterium xenopi. Am Rev Respir Dis 123:104–109

    PubMed  CAS  Google Scholar 

  25. Hoffner SE (1994) Pulmonary infections caused by less frequently encountered slow-growing environmental mycobacteria. Eur J Clin Microbiol Infect Dis 13:937–941

    Article  PubMed  CAS  Google Scholar 

  26. Research Committee of the British Thoracic Society (2001) First randomised trial of treatments for pulmonary disease caused by M. avium intracellulare, M. malmoense, and M. xenopi in HIV negative patients: rifampicin, ethambutol, and isoniazid versus rifampicin and ethambutol. Thorax 56:167–172

    Article  Google Scholar 

  27. Banks J, Hunter AM, Campbell IA (1984) Pulmonary infection with Mycobacterium xenopi: review of treatment and response. Thorax 39:376–382

    PubMed  CAS  Google Scholar 

  28. Griffith DE, Wallace RJ (1996) New developments in the treatment of nontuberculous mycobacterial disease. Semin Respir Iinfect 11:301–310

    CAS  Google Scholar 

  29. Alangaden GJ, Lerner SA (1997) The clinical use fluoroquinolones for the treatment of mycobacterial diseases. Clin Infect Dis 25:1213–1221

    Article  PubMed  CAS  Google Scholar 

  30. Stumpe KD, Zanetti M, Weishaupt D, Hodler J, Boos N, von Schulthess GK (2002) FDG positron emission tomography for differentiation of degenerative and infectious endplate abnormalities in the lumbar spine detected on MR imaging. AJR 179:1151–1157

    PubMed  Google Scholar 

  31. Risse JH, Grünwald F, Gassel F, Biersack HJ, Schmitt O (2001) Fluorine-18 fluorodeoxyglucose positron emission tomography findings in spondylodiscitis: preliminary results. Eur Spine J 10:534–539

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Cologne, Josef-Stelzmann-Str. 9, 50924, Cologne, Germany

    R. Sobottke, K. Zarghooni, M. Koriller, J.-W. P. Michael, K.-S. Delank & P. Eysel

  2. Department of Microbiology, Immunology, Hygiene, University of Cologne, Goldenfelsstr. 19-21, 50935, Cologne, Germany

    H. Seifert

  3. Department of Medicine, University of Cologne, Kerpener Str. 62, 50937, Köln, Germany

    G. Faetkenheuer

Authors
  1. R. Sobottke
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  2. K. Zarghooni
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  4. G. Faetkenheuer
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  5. M. Koriller
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  6. J.-W. P. Michael
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  7. K.-S. Delank
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  8. P. Eysel
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Correspondence to R. Sobottke.

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Sobottke, R., Zarghooni, K., Seifert, H. et al. Spondylodiscitis caused by Mycobacterium xenopi . Arch Orthop Trauma Surg 128, 1047–1053 (2008). https://doi.org/10.1007/s00402-007-0553-y

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  • DOI: https://doi.org/10.1007/s00402-007-0553-y

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