Abstract
Nontuberculous mycobacteria represent an uncommon but important cause of infection of the musculoskeletal system. Such infections require aggressive medical and surgical treatment, and cases are often complicated by delayed diagnosis. We retrospectively reviewed all 14 nonspinal cases of nontuberculous mycobacterial musculoskeletal infections treated over 6 years by orthopedic surgeons at a university-affiliated tertiary referral center. All patients required multiple antimicrobial agents along with aggressive surgical treatment; 13 of 14 patients ultimately achieved cure. Four patients required amputation to control the infection. Half these patients were immunosuppressed by medications or other medical illness when they sought care at the referral center. Six cases involved joint prostheses; all ultimately required hardware removal and placement of an antimicrobial spacer for eradication of infection. Our findings highlight the importance of vigilance for nontuberculous mycobacterial musculoskeletal infection, particularly in patients who are immunosuppressed or have a history of musculoskeletal surgery.
Highlights
In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases
We reviewed all cases of nonspinal nontuberculous mycobacterial (NTM) musculoskeletal infection treated at the University of Colorado Hospital (UCH; Aurora, CO, USA) over a 6-year period by a multidisciplinary team of providers at UCH and National Jewish Health (NJH; Denver, CO, USA), a renowned center for mycobacterial research and treatment that receives referrals for difficult-to-treat NTM infections from across the United States
Case Ascertainment We identified all cases of nonspinal NTM musculoskeletal infections treated by orthopedic surgeons at UCH during the study period using a registry of NTM musculoskeletal infections
Summary
In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Describe clinical characteristics of patients with nontuberculous mycobacterial (NTM) nonspinal musculoskeletal infections, according to a case series of 14 patients treated at University of Colorado Hospital (UCH) over a 6-year period
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