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Mycobacterium chelonae and Mycobacterium fortuitum infection following open fracture: A case report and review of the literature

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Author(s): Kwan K | Ho S

Journal: Indian Journal of Medical Microbiology
ISSN 0255-0857

Volume: 28;
Issue: 3;
Start page: 248;
Date: 2010;
Original page

Keywords: Atypical mycobacteria | infection | open fracture | trauma

ABSTRACT
We report a case of dual nontuberculous mycobacterial infections complicating an open distal radius and ulna fracture after polytrauma in a 35-year-old man. There was persistent wound discharge after definitive fixation of this fracture, but microbiological cultures did not yield any organism. The patient underwent multiple debridement, and subsequent tissue grew Mycobacterium chelonae and Mycobacterium fortuitum. Despite appropriate chemotherapy and surgical debridement the infection persisted until radical bone excision and tissue debridement were done. This case indicates that nontuberculous mycobacterial infections should be considered when conventional microbiological assays fail to identify the infecting agent in suspected osteomyelitis following open fracture. A combination of radical debridement, including removal of infected bone, and prolonged antimicrobial therapy are required to eradicate the infection completely.

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