Nontuberculosis Mycobacterium Infections in Orthopaedic Surgery: Review of the Epidemiology, Pathogenesis, Diagnosis, and Treatment Guidelines.

Nontuberculosis Mycobacterium infections are rare but devastating infections in orthopaedic surgery. The complexity of treatment and the high rate of treatment failure for nontuberculosis Mycobacterium infections illustrate their unique pathogenesis and success at evading normal immune responses. To date, there is no formal treatment algorithm developed for managing these infections in orthopaedic surgery. Successful eradication relies on prolonged culture-specific antibiotic therapies coupled with surgical resection, implant/prosthesis removal, and occasionally amputations. These multidrug therapies often have a high rate of complications, drug-drug interactions, and poor tolerance, further increasing the complexity of treatment. Outlining the epidemiology, pathogenesis, diagnosis, and treatment guidelines of these rare but detrimental infections is essential to improving treatment success.