Vertebral osteomyelitis caused by nontuberculous mycobacteria: a case series of 23 patients and a review of 108 cases in the literature
Abstract
BACKGROUND: Nontuberculous mycobacteria (NTM) are ubiquitous environmental opportunistic pathogens that rarely cause spinal infections. The clinical presentation, diagnostic process, and treatment strategies for NTM vertebral osteomyelitis often resemble those of spinal tuberculosis, posing significant challenges to clinical management. OBJECTIVE: This study aims to systematically analyze the clinical characteristics, imaging findings, microbial profiles, treatment approaches, and outcomes of NTM vertebral osteomyelitis, with a comparative review of relevant global literature to further elucidate their features. METHODS: We retrospectively analyzed 23 cases of NTM vertebral osteomyelitis diagnosed at our institution from 2021 to 2025. Inclusion criteria included spinal lesions with local and/or systemic symptoms, confirmed by positive NTM culture and/or molecular testing of biopsy or aspirate samples. Exclusion criteria were: (1) infections confirmed to be caused by Mycobacterium tuberculosis or other non-NTM pathogens, or cases with incomplete data; (2) patients with severe heart, liver, kidney dysfunction, or psychiatric disorders. Data collected included demographics, medical history, clinical presentation, imaging and laboratory findings (e.g., white blood cell count, C-reactive protein, erythrocyte sedimentation rate), microbiological profiles, and treatment outcomes. A literature review was conducted using PubMed, Google Scholar, and MEDLINE to retrieve studies on NTM…
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