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Case Reports in Orthopedics
Volume 2015, Article ID 963138, 5 pages
http://dx.doi.org/10.1155/2015/963138
Case Report

A Challenging Case of Multifocal Mycobacterium marinum Osteoarticular Infection in a Patient with Anorexia Nervosa

1Kaiser Permanente Infectious Disease Department, 9900 SE Sunnyside Road, Clackamas, OR 97015-977, USA
2Division of Infectious Disease, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, 420 East North Avenue, Pittsburgh, PA 15212, USA

Received 18 March 2015; Accepted 24 May 2015

Academic Editor: Pedro Carpintero

Copyright © 2015 Katie Sharff et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Disseminated infection due to Mycobacterium marinum is rare but has been described in immunosuppressed and transplant recipients. We describe a case of multifocal osteoarticular involvement by this pathogen in a patient with anorexia nervosa. Serial surgical debridements and a prolonged course of antimicrobial therapy including intravenous amikacin, imipenem, and oral ethambutol and azithromycin were needed to treat the infection. Cell mediated immune deficits related to the patient’s anorexia nervosa predisposed her to a severe infection with M. marinum. Aggressive surgical intervention in conjunction with multiple antimicrobial agents helped cure the infection.