Mycobacterium farcinogenes infection after fracture repair of the tibia and fibula

Abstract

Mycobacterium farcinogenes is the causative agent of bovine farcy. M. farcinogenes shares common properties with rapidly growing mycobacteria, and distinguishing between M. farcinogenes and M. fortuitum is reportedly complex and challenging. Moreover, few studies have isolated M. farcinogenes from human clinical samples.A previously healthy 37-year-old male construction worker presented to the emergency department after a severe injury and was diagnosed with a Gustilo-Anderson type ⅢA fracture. After an uneventful postoperative period of two months, he experienced pain and serous discharge from the upper shin and lower calf region. Frequent debridement provided no relief, and the pathology cultures of the tissue were negative. However, M. farcinogenes was isolated from the fluid of the wound. The patient’s symptoms gradually improved with anti-mycobacterial drug treatment.Nontuberculous mycobacterial infections, including those caused by M. farcinogenes, should be considered in patients developing soft tissue infections despite negative pyogenic bacterial cultures several months after sustaining an open fracture.

Keywords

• Fibula
• Fracture
• Mycobacterium farcinogenes
• Tibia
• Nontuberculous mycobacteria