Osteomyelitis of the femur caused by Mycobacterium chelonae: A case report

Mycobacterium chelonae can cause infections of the lungs and soft tissues. However, osteomyelitis of the proximal femur caused by M. chelonae has not previously been reported. Here, we present such a case in an elderly patient. A 69-year-old man presented with right hip pain for 1 month. The combination of MRI, laboratory examination, and next generation sequencing yielded the diagnosis of femoral osteomyelitis due to M. chelonae. Clarithromycin, moxifloxacin hydrochloride, linezolid, and amikacin were treated for 2 months. However, there was no significant improvement. Therefore, surgical debridement was taken, followed by combined treatment with amikacin, imipenem/cilastatin sodium, and clarithromycin 4 months. Re-examination a year later showed a significant reduction in the extent of disease. Femoral osteomyelitis caused by M. chelonae is difficult to diagnose and treat. The key to successful treatment of this case is surgical debridement, as well as the combined antimicrobial agents.