Age / Sex : 74 / M

Chief complaint : low back pain, left radiating pain


What is your diagnosis?


Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy: 송유선(You Seon Song), 부산대학교병원(Pusan National University Hospital)

Vertebral NTM infection

Discussion

Findings

1. Large prevertebral and epidural abscess formation with calcification

2. Vertebral body osteomyelitis with skip lesion



Vertebral osteomyelitis (VO) due to NTM is very rare

Frequently misdiagnosed as due to M. tuberculosis because of the similarity of their clinical, laboratory and radiographic characteristics

In the spine, atypical mycobacterial osteomyelitis shares similar morphologic abnormalities with tuberculous spondylitis


Reference

Kim CJ, Kim UJ, Kim HB et al. Vertebral osteomyelitis caused by non-tuberculous mycobacteria: Predisposing conditions and clinical characteristics of six cases and a review of 63 cases in the literature. 
INFECTIOUS DISEASES, 2016 Jul;48(7):509-16