Possible correlation between Mycobacterium abscessus subsp. massiliense spondylodiscitis and spinal anesthesia: Diagnostic and therapeutic challenges.
Henrique Soares Casaccio, Júlia Lustosa Martinelli, Pedro Augusto Simão Vasconcellos et al.
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Case in brief
A 57-year-old man experienced back pain following spinal anesthesia for prostate surgery. Six months later, he underwent decompressive laminectomy, with initial cultures negative for mycobacteria. Two years post-surgery, a paravertebral abscess culture identified Mycobacterium abscessus subsp. massiliense. Treatment with a combination of antibiotics led to significant clinical and radiological improvement.
What made this case unusual
This case is notable for the temporal association between spinal anesthesia and the development of M. abscessus spondylodiscitis, a rare infection.
Diagnostic / clinical pearl
Clinicians should consider Mycobacterium abscessus in patients with persistent back pain following spinal procedures, especially when initial cultures are negative.
Why it matters
Understanding the potential link between spinal anesthesia and rare infections like M. abscessus can aid in timely diagnosis and management.