Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2021; 9(29): 8879-8887
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8879
Lumbar infection caused by Mycobacterium paragordonae: A case report
Ying-Zheng Tan, Ting Yuan, Liang Tan, Yu-Qiu Tian, Yun-Zhu Long
Ying-Zheng Tan, Ting Yuan, Yu-Qiu Tian, Yun-Zhu Long, Department of Infectious Diseases, Zhuzhou Central Hospital, Zhuzhou 412000, Hunan Province, China
Liang Tan, Department of Spinal Surgery, Zhuzhou Central Hospital, Zhuzhou 412000, Hunan Province, China
Author contributions: Tan YZ and Yuan T analyzed the data and drafted the manuscript; Tan L and Tian YQ analyzed and interpreted the imaging data, pathological examinations, and the results of metagenomic next-generation sequencing; Long YZ was responsible for the revision of the manuscript for important intellectual content; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors report no potential conflicts of interest for this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Zhu Long, MD, Chief Physician, Doctor, Department of Infectious Diseases, Zhuzhou Central Hospital, No. 116 Changjiangnan Road, Tianyuan District, Zhuzhou 412000, Hunan Province, China. 1271915949@qq.com
Received: June 7, 2021
Peer-review started: June 7, 2021
First decision: June 25, 2021
Revised: June 30, 2021
Accepted: August 2, 2021
Article in press: August 2, 2021
Published online: October 16, 2021
Processing time: 129 Days and 21.2 Hours
Abstract
BACKGROUND

Mycobacterium paragordonae (M. paragordonae), a slow-growing, acid-resistant mycobacterial species, was first isolated from the sputum of a lung infection patient in South Korea in 2014. Infections caused by M. paragordonae are rare.

CASE SUMMARY

Herein, we report the case of a 53-year-old patient who presented with fever and low back pain. Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation. After anti-infective and diagnostic anti-tuberculosis treatment, the patient had no further fever, but the back pain was not relieved. Postoperatively, the necrotic material was sent for pathological examination, and all tests related to tuberculosis were negative, but pus culture suggested nontuberculous mycobacteria. The necrotic tissue specimens were subjected to metagenomic next-generation sequencing, which indicated the presence of M. paragordonae. Finally, the infecting pathogen was identified, and the treatment plan was adjusted. The patient was in good condition during the follow-up period.

CONCLUSION

M. paragordonae, a rare nontuberculous mycobacterium, can also cause spinal infections. In the clinic, it is necessary to identify nontuberculous mycobacteria for spinal infections similar to Mycobacterium tuberculosis.

Keywords: Mycobacterium paragordonae; Nontuberculous mycobacteria; Spinal infection; Lumbar spine infection; Metagenomic next-generation sequencing; Mycobacterium tuberculosis; Case report

Core Tip: Mycobacterium paragordonae (M. paragordonae) is a slow-growing, acid-resistant mycobacterial species. We present herein a 53-year-old patient who presented with fever and low back pain. Lumbar nuclear magnetic resonance imaging revealed the destruction of the lumbar vertebra with peripheral abscess formation. After anti-infective and diagnostic anti-tuberculosis treatment, the patient had no further fever, but the back pain was not relieved. Postoperatively, the necrotic material was sent for pathological examination, and all tests related to tuberculosis were negative. The necrotic tissue specimens were subjected to metagenomic next-generation sequencing, which indicated the presence of M. paragordonae. Finally, the infecting pathogen was identified, and the treatment plan was adjusted. The patient was in good condition during the follow-up period.