Mycobacterium bolletii Osteomyelitis of the Metaphyseal Distal Radius Treated With Amikacin Antibiotic Beads.

Abstract

Mycobacterium bollettii, a subset of the group M. abscessus, is a slow-growing, nontuberculous mycobacterium that was first characterized in the early 2000s. We report a case of M. bollettii infection in an otherwise healthy 49-year-old man who sustained an open fracture of the right distal radius. After his initial surgery, the patient presented 1 month later with wound drainage requiring hardware removal and was treated with intravenous antibiotics. However, there was a persistent infection. We treated his osteomyelitis with debridement and placement of amikacin antibiotic beads. We selected this particularly uncommon antibiotic cement specifically to address the nontuberculous mycobacterium. The purpose of this report is to alert treating providers to the possibility of nontuberculous mycobacterium infections when an inflammatory process persists and to provide guidelines for the use of amikacin solution to produce antibiotic beads.