Abstract
We report a rare case of Brodie’s abscess caused by Mycobacterium kansasii (M. kansasii). Our patient is a 39-year-old male who presented with right foot pain a month after a new diagnosis of HIV infection. X-ray and MRI were done, and the diagnosis of Brodie's abscess was confirmed. Surgical debridement was done, and bone cultures grew M. kansasii after five weeks. Brodie’s abscess is a subacute form of osteomyelitis usually caused by Staphylococcus. Some other bacteria have been implicated in several case reports. To best of our knowledge, this is the first case of Brodie's abscess caused by M. kansasii. M. kansasii is the atypical mycobacteria causing infections in immunocompromised hosts as in HIV patients with low CD4 count. M. kansasii is usually associated with lung infections with rare extrapulmonary manifestations as in our case.
Highlights
HIV patients with low CD4 count are prone to infections with atypical mycobacteria like Mycobacterium kansasii (M. kansasii)
We present a case of a young HIV patient with Brodie's abscess of tibia caused by M. kansasii
M. kansasii is an unusual pathogen presenting as osteomyelitis and Brodie’s abscess
Summary
HIV patients with low CD4 count are prone to infections with atypical mycobacteria like Mycobacterium kansasii (M. kansasii). We present a case of a young HIV patient with Brodie's abscess of tibia caused by M. kansasii. Given high suspicion for TB osteomyelitis, he was started on four-drug antitubercular therapy (rifabutin 300 mg daily, isoniazid 300 mg daily, ethambutol 1,200 mg daily, pyrazinamide 1,500 mg daily, and pyridoxine 50 mg daily), and broad-spectrum antibiotics were discontinued. His ART regimen was modified to avoid drug interactions. His bone cultures came back positive for M. kansasii His regimen was adjusted according to sensitivities (rifabutin 300 mg daily, isoniazid 300 mg daily, ethambutol 1,200 mg daily, and pyridoxine 50 mg daily were continued, and pyrazinamide was discontinued). He was advised to continue with medications for nine months
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