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Atypical Mycobacterial Infections

Chapter 90 reviews atypical mycobacterial infections of the musculoskeletal system, which are uncommon. At least 15 species of atypical mycobacteria have been mentioned in the literature as the cause of musculoskeletal infection. There is no evidence of human-to-human transmission, and therefore these infections do not pose a public health risk. The patients may present with nonhealing wounds, cellulitis, superficial and deep fasciitis, tenosynovitis, myositis, soft tissue abscesses, osteomyelitis, septic arthritis, and infectious spondylitis. Imaging findings are nonspecific and the differential diagnosis includes tuberculosis and various fungal and bacterial infections. The diagnosis is made by tissue sampling and culturing. With negative cultures, identification of different Mycobacterium species can be made by using polymerase chain reaction. Drug-resistant infections warrant surgical debridement.