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Table 1 Summary of clinical details from published cases of MAC vertebral osteomyelitis in patients without a known HIV diagnosis

From: Mycobacterium Avium complex vertebral osteomyelitis in the absence of HIV infection: a case report and review

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
  1. F female, M male, LE lower extremity, SLE systemic lupus erythematosus, COPD chronic obstructive pulmonary disease, ILD interstitial lung disease, NA data not available, TB Mycobacterium tuberculosis, PCR polymerase chain reaction