# A post-surgical case of rib osteomyelitis and pleural abscess caused by mycobacterium abscessus after 6 years of lung cancer surgery

## TL;DR

A man developed a rare infection caused by Mycobacterium abscessus six years after lung cancer surgery, which was successfully treated with a long-term antibiotic regimen.

## Contribution

This case highlights a rare instance of M. abscessus causing osteomyelitis and pleural abscess, offering insights into its treatment strategy.

## Key findings

- M. abscessus was identified as the causative agent through PCR from a bone biopsy.
- A 20-month combination antibiotic therapy successfully treated the infection without surgery.
- Osteomyelitis caused by M. abscessus is extremely rare and requires prolonged treatment.

## Abstract

A 69-year-old man followed post lung cancer surgery for 6 years presented with back pain. His imaging revealed a pleural abscess and rib osteomyelitis along with the surgical site. Therefore, bone biopsy and culture were performed and the organism was diagnosed as Mycobacterium abscessus by PCR method. As such, the combination antibiotics therapy initiated with imipenem, amikacin, and clarithromycin, and then continued with faropenem, minocycline, clarithromycin, and moxifloxacin for 20 months, successfully surpassing the disease without additional surgery. Although the number of non-tuberculosis mycobacterial infection has been increasing, osteomyelitis caused by M. abscessus is extremely rare. This time, we describe the clinical course and current treatment strategy for M. abscessus.