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Mycobacterium arosiense, an unexpected cause of osteomyelitis in a patient with sarcoidosis: a case report

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  1. Differences in mortality in patients undergoing surgery for infective endocarditis according to age and valvular surgery

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  2. Renal function in Ethiopian HIV-positive adults on antiretroviral treatment with and without tenofovir

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  3. The cause of death in bacterial meningitis

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  1. Renal function in Ethiopian HIV-positive adults on antiretroviral treatment with and without tenofovir

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  2. Lyme neuroborreliosis in adults: A nationwide prospective cohort study

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  3. Tuberculosis among Patients Undergoing Solid Organ Transplantation or Dialysis in a Low-Endemic Country, 2004-2017

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  4. Vi skal blive bedre til at teste for latent tuberkulose i Danmark

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BACKGROUND: Nontuberculous mycobacteria belonging to the Mycobacterium avium complex are recognized as opportunistic pathogens to humans. Mycobacterium arosiense is one of the novel members of the Mycobacterium avium complex. The organism has only rarely been reported in human clinical cases and may be routinely misidentified.

CASE PRESENTATION: An adult male with a history of a discus prolapse and sarcoidosis presented with high fever and a strong back pain with projection to the extremities. A Magnetic Resonance Imaging scan of columna revealed a tumor suspect process at thoracic vertebrae 11/12 with changes at the second lumbar vertebra, which was partly removed by laminectomy. Biopsy smears revealed acid-fast bacilli and turned out to be Mycobacterium tuberculosis complex PCR negative. The routine line probe assay INNO-LiPa v2 (INNOGENETICS NV, Gent), which differentiates 16 mycobacterial species indicated the presence of a not readily identifiable NTM species. Whereas, the GenoType Mycobacterium CM v2.0 (HAIN Lifescience GmbH) that routinely differentiates 14 clinically relevant mycobacteria revealed a Mycobacterium intracellulare species. However, additional diagnostic sequencing of the 16S rRNA gene confirmed the presence of a Mycobacterium arosiense species.

CONCLUSIONS: This is the second unusual case of osteomyelitis with clinical significance ever to be reported, caused by Mycobacterium arosiense and complicated by an underlying sarcoidosis. Mycobacterium arosiense has rarely been reported clinically and the first description of the species was identified as the cause of osteomyelitis in a child with a hereditary partial interferon gamma deficiency. Symptoms attributed to sarcoidosis waned on Mycobacterium arosiense treatment and it is inconclusive whether the patient ever suffered from sarcoidosis. Mycobacterium arosiense was misidentified by the GenoType as Mycobacterium intracellulare and implicates that the diagnosis requires supplemental sequencing of the 16S rRNA gene.

Original languageEnglish
JournalBMC Infectious Diseases
Volume19
Issue number1
Pages (from-to)994
ISSN1471-2334
DOIs
Publication statusPublished - 26 Nov 2019

ID: 59183189