SPINAL OSTEOMYELITIS DUE TO MYCOBACTERIUM-AVIUM-INTRACELLULARE IN AN ELDERLY MAN WITH STEROID-INDUCED OSTEOPOROSIS

Disseminated mycobacterial infections are becoming widely appreciated among immunosuppressed and debilitated persons. Specific microbiologic diagnosis may take several weeks, requiring empiric therapy in the in terim. A case of an elderly man undergoing steroid treatment who devel oped spinal osteomyelitis initially thought to be caused by Mycobacter ium tuberculosis is described. He was eventually shown to have infecti on due to M. avium-intracellulare, which requires a different therapeu tic approach. The importance of considering atypical mycobacteria in s ystemic infections and the value of aggressive antimicrobial therapy i n conjunction with a comprehensive rehabilitation program during hospi talization are emphasized in order to provide optimal management and p revent further disability.