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Atypical mycobacterial spondylitis in HIV-negative patients identified by genotyping

¹ Africa Centre for Health and Population Studies.
² Department of Orthopaedic Surgery
³ Department of Virology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Durban, 4013, South Africa.
⁴ HIV-1 Immunopathology and Therapuetics Research Program, Department of Immunology, Institute of Pathology, University of Pretoria, 5, Baphela Road Pretoria, 0001, South Africa.

Correspondence should be sent to Professor S. Govender; e-mail: katia{at}ukzn.ac.za

Non-tuberculous mycobacterial infections pose a significant diagnostic and therapeutic challenge. We report two cases of such infection of the spine in HIV-negative patients who presented with deformity and neurological deficit. The histopathological features in both specimens were diagnostic of tuberculosis. The isolates were identified as Mycobacterium intracellulare and M. fortuitum by genotyping (MicroSeq 16S rDNA Full Gene assay) and as M. tuberculosis and a mycobacterium other than tuberculosis, respectively, by culture. There is a growing need for molecular diagnostic tools that can differentiate accurately between M. tuberculosis and atypical mycobacteria, especially in regions of the developing world which are experiencing an increase in non-tuberculous mycobacterial infections.