Table 1 Summary of clinical details from published cases of MAC vertebral osteomyelitis in patients without a known HIV diagnosis
REFERENCE | Country | Age, SEX | Clinical manifestations | Underlying Conditions | Site of Involvement | Antibacterial/ Months of Therapy | Surgical Intervention | Diagnosis Method/ Weeks to Positivity | Biopsies |
|---|---|---|---|---|---|---|---|---|---|
9 | U.S.A. | 72, F | Mid-thoracic back pain, fevers, LE* weakness, decreased sensation | Polymyositis, steroid use | T11-L1 osteomyelitis, extra-dural soft tissue mass compressing anterior spinal cord | clarithromycin, ethambutol, rifampin/NA | No | (Acid fast stain lead to TB diagnosis) Tissue culture/ NA | 1 |
10 | U.S.A. | 62, F | Low back pain | None | Paraspinal abscess at L5-S1, destructive changes of L5 and S1 vertebral bodies. | clarithromycin, clofazamine, ethambutol/21 | Yes | Tissue culture/NA | 1 |
11 | U.S.A. | 35, M | Right shoulder pain | SLE, steroid use | Right humeral head osteomyelitis, thoracolumbar infection with associated paraspinal abscess | ethambutol, isoniazid, streptomycin/24+, until death | Yes | Tissue culture/NA | 1 |
12 | Japan | 76, F | MAC pulmonary infection, low back pain | None | T4-T5 osteomyelitis | clarithromycin, moxifloxacin, rifampicin/NA | Yes | Tissue culture/NA | 1 |
13 | U.S.A. | 79, M | Low back pain, urinary incontinence | SLE, steroid use, osteoporosis | Thoracolumbar osetomyelitis with spinal cord compression due to soft tissue paraspinal mass. 10 cm lung mass with pleural effusion. | Initial empiric: Isoniazid, rifampin, pyrazinamide/2.25 Definitive: amikacin/4, clindamycin, clofazamine, ethambutol, rifampin/6 - until death | Yes | (Acid fast stain lead to TB diagnosis) Tissue culture/9 | 2 |
17 | Japan | 38, F | Low back pain | SLE, steroid use | Septic arthritis of bilateral knees, T8-T9 paravertebral abscess and T9 osteomyelitis | clarithromycin, ethambutol, rifampin/12 | Yes | Tissue culture/NA | 1 |
17 | Japan | 50, M | Low back pain | None | Paravertebral abscess and psoas abscess at level of L4, osteodiscitis at L2-L5. | clarithromycin, ethambutol, rifampin/+ 12 | Yes | Tissue culture/5 | 1 |
18 | China | 60, M | Low back pain | None | L2-L3 osteomyelitis with psoas abscess | Initial empiric: ethambutol, isoniazid, pyrazinamide, rifampicin/3. Definitive: amikacin/2, ethambutol, rifampicin/12 | Yes | (Pathology lead to TB diagnosis) Tissue culture/12 | 1 |
19 | Japan | 67, M | Low back pain, fever | Diabetes mellitus | T spine to L spine with psoas abscess | clarithromycin, cycloserine, ethambutol, rifampicin, streptomycin sulfate/+ 24 | Yes | PCR* from sinus tract/8 | 1 |
20 | Australia | 70, F | Low back pain, paraplegia | Osteoporosis, chronic bronchitis | T12 osteomyelitis with spinal cord compression | clarithromycin, ethambutol, rifampin/NA | No | Tissue culture/2 | 2 |
21 | U.S.A. | 60, F | Low back pain, fevers, productive cough | Sarcoidosis, steroid use, COPD, osteoporosis, splenectomy | T7-T9 osteomyelitis with paraspinal abscess causing cord compression at T8-T9. | Initial empiric: clarithromycin, ethambutol, isoniazid, rifampin. Definitive: clarithromycin, ethambutol, rifampin/24 | Yes | (Acid-fast stain lead to TB diagnosis) Tissue culture/NA | 1 |
26 | U.S.A. | 27, F | Low back pain, fevers, LE weakness and hyporeflexia | SLE, steroid, hydroxychloroquine use | L5 osteomyelitis, soft tissue mass extending into spinal canal and anteriorly into retroperitoneum, 1 cm breast nodule | cycloserine, ethambutol, rifampin, streptomycin/20 months – until death. | Yes | Tissue culture from breast/NA | 1 |
27 | U.S.A. | 39, M | Low back pain, paraplegia | None | T6 and T7 destruction, paraspinal abscess with spinal cord impingement. | ciprofloxacin, erythromycin, ethambutol/6 | Yes | Tissue culture/NA | 1 |
28 | U.S.A. | 31, F | Back pain, painful adenopathy | None | Axillary abscess, sternal abscess, T7-T8 osteomyelitis with paraspinal abscess, metastatic osteomyelitis to proximal femurs, pelvis, sternum, and distal radius | Initial empiric: clarithromycin, isoniazid, pyridoxine, rifampin Definitive: ciprofloxacin, clarithromycin, cycloserine, ethambutol, rifampin/24 | No | (Acid-fast stain from abscesses lead to TB diagnosis) Tissue culture/NA | 1 |
29 | U.S.A. | 12, F | Left leg pain | None | Multifocal osteomyelitis involving the tibias, right femur, pelvis, spine and orbit | NA | Yes | Tissue culture/NA | 1 |
30 | Australia | 70, M | Back pain, ataxia | ILD, steroid use | T5-T7 osteomyelitis with vertebral destruction | NA | Yes | Tissue culture/NA | 1 |