Non tuberculous mycobacteria related spondylodiscitis: a case report and systematic literature review.

Mycobacterium xenopi and Non Tuberculous Mycobacteria (NTM) are rare causes of spondylodiscitis (SD). The aim of this study was to highlight the relevance of considering these pathogens in differential diagnosis of slow growing SD, obtaining the correct diagnosis and evaluating the key points of management and therapy approach. A case of surgically treated Mycobacterium xenopi SD is reported. A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. The research was conducted on MEDLINE, PubMed and Scopus using as search-terms "vertebral", "spinal", "infection", "spondylodiscitis", "discitis", "osteomyelitis", "atypical", "nontuberculous", "mycobacterium". After the screening of 444 titles and abstracts, 113 papers were considered eligible for the full-text analysis. Seventy-seven studies that met inclusion criteria were finally included in the review. Overall, including our report, 91 patients affected by NTM SD were analyzed in this systematic review Conclusion: This review highlights the rarity of spinal infections due to NTM and the difficulty of their management. A tailored approach with prolonged antibiotic therapy, eventually associated with surgery in selected cases were suggested for the treatment of NTM infections.