RT Journal Article SR Electronic T1 Non-tuberculous mycobacterial thoracic osteomyelitis in an immunocompetent host: a rare presentation of Mycobacterium kansasii JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e249629 DO 10.1136/bcr-2022-249629 VO 15 IS 5 A1 Taylor Becker A1 Matthew Smith A1 Meredith Parsons A1 Michihiko Goto YR 2022 UL http://casereports.bmj.com/content/15/5/e249629.abstract AB An immunocompetent man in his 40s presented with 3 months of mid-thoracic back pain which progressed to include progressive paraesthesias and lower extremity weakness. Investigations revealed thoracic spine osteomyelitis with signs of cord compression. He underwent neurosurgical intervention, including laminectomy, spinal cord decompression and partial resection of an epidural mass. Initial intraoperative biopsy and surgical pathology results were concerning for an acid-fast bacillus as the causative pathogen, and the patient was given empiric therapy for presumed Mycobacterium tuberculosis. However, microbiology speciation revealed the presence of the non-tuberculous mycobacterium (NTM) Mycobacterium kansasii, which resulted in an alteration of his antimicrobial therapy. This case highlights the importance of considering NTM as a possible aetiology of spinal osteomyelitis, even among immunocompetent individuals or in low-prevalence regions.