Epidural abscess caused by Mycobacterium abscessus

BACKGROUND Mycobacterium abscessus is a member of the Rapidly Growing Mycobacterium (RGM). The incidence of Mycobacterium abscessus infections has steadily been increasing over the last decade. We report the case of an epidural abscess caused by Mycobacterium abscessus. RGM's have infrequently been reported as spinal infections and we found no prior cases reporting M. abscessus as the definitive etiologic agent of an epidural abscess. CASE REPORT A 50 year old female presented with significant back pain and was found to have an epidural abscess by magnetic resonance imaging. The abscess was drained via needle. Initial cultures were negative for bacterial pathogens, and the patient was discharged to a skilled nursing facility for empiric antibiotic treatment. Eventually the culture grew Mycobacterium abscessus. The patient had unfortunately left the nursing facility and was lost to follow up. CONCLUSIONS Mycobacterium abscessus is an increasingly recognized pathogen with particular risk factors that physicians should be aware of. Central nervous system infections are rare, but do occur. Treatment is difficult, though multiple antibiotic regimens have been reported successful. Surgical debridement is often needed.