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KMID : 0828520130170030138
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Journal of the Korean Geriatrics Society
2013 Volume.17 No. 3 p.138 ~ p.142
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Department of internal medicine, Hanyang University College of medicine, 2Department of Radiology, Hanyang University College of medicine
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Kim Hae-Su
Kim Ji-Eun
Choi Jeong-Im
Yoon Hye-Jin
Kim Jae-Ha
Kim You-Shin
Kwak Dong-Shin
Lee Jung-Kyu
Lee Seung-Hun
Pai Hyun-Joo
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Abstract
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Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung disease, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with anti-tuberculous drugs. Fifty six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were changed to clarithromycin, rifabutin and ethambutol. After 3 months of M. intracellulare treatment, radiologic finding showed increase of epidural abscess. According to the susceptibility, the patient received intravenous amikacin for four weeks and then oral ciprofloxacin in addition to clarithromycin, rifabutin and ethambutol. The patient is being treated with the medication for 13 months and showing a slow improvement.
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KEYWORD
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Mycobacterium intracellulare, nontuberculos mycobacteria, osteomyelitis
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