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Non-Tuberculous Mycobacteria Caused Calcaneal Osteomyelitis after Ankle Local Injection Therapy by Xiaoying Liang, Shaoyun Nong, Lixin Zhou, Steven Hochwald, Huayi Huang

Background: Non-tuberculous mycobacteria (NTM) are ubiquitous, being found in water, soil, and animals. Al-though more than 170 species have been identified, the majority of human NTM diseases are caused by fewer than 20 species. Reported mycobacteria osteomyelitis cases are fewer than 200 worldwide, with patient age ranging from 6 - 88 years. Many underlying conditions, including immunocompromised patients, wounds, and physical exercise, are associated with the disease. When treating this infection, the first step to consider is an early diagnosis in the course of illness to prevent significant bone destruction and loss of function. To treat mycobacteria osteomyelitis, prolonged antibiotic administration, often in conjunction with surgical intervention, is typically required. Methods and
Results: A case of non-tuberculous mycobacteria infection leading to calcaneal osteomyelitis after ankle local injection therapy is diagnosed with magnetic resonance imaging (MRI), bacteria culture, and is further confirmed by the Next Generation Sequencing of the nucleotides. The patient recovered gradually after more than 8 months of treatment.
Conclusions: Diagnosis of non-tuberculous mycobacteria infection could be challenging especially with osteomyelitis. Early diagnosis is critical to prevent prolonged treatment and adverse effects, as well as destruction of the bone and resulting dysfunction.

DOI: 10.7754/Clin.Lab.2020.201143