Possible correlation between Mycobacterium abscessus subsp. massiliense spondylodiscitis and spinal anesthesia: Diagnostic and therapeutic challenges.

Spinal infections caused by Mycobacterium abscessus are rare and difficult to treat. We report the first case of M. abscessus subsp. massiliense spondylodiscitis temporally associated with spinal anesthesia. A 57-year-old man developed back pain after undergoing spinal anesthesia for prostate surgery. Six months later, decompressive laminectomy was performed; results for bacterial and fungal culture and molecular testing for Mycobacterium tuberculosis were negative. Two years later, a mycobacterial culture of material from a paravertebral abscess revealed the presence of M. abscessus, later identified as subsp. massiliense. Treatment with imipenem, amikacin, tigecycline, clofazimine, and clarithromycin resulted in clinical and radiological improvement. This report highlights the diagnostic and therapeutic challenges of this case.