Mycobacterium abscessus mimicking tubercular spondylodiscitis following ozone therapy: A case report and review of literature
Shahi PB, Panigrahi V, Adsul N, Kumar M, et al. Surgical Neurology International, 2020.
- Study type
- Case report
- People studied
- 1 person
- Population
- Healthy, non-immunocompromised 43-year-old woman given a fluoroscopically guided percutaneous ozone treatment for degenerative disc disease at L4-L5
- Published
- 2020, Surgical Neurology International
- Identifiers
- PMID 32363058, DOI 10.25259/SNI_50_2019
What the authors reported
Three months after a fluoroscopically guided percutaneous ozone treatment at L4-L5, the patient had severe back pain, radiculopathy in both legs, a partial right foot drop, and raised CRP and ESR; MRI showed L4-L5 spondylodiscitis. Mycobacterium abscessus grew from epidural pus taken at fusion surgery. After a later wound debridement she was treated with amikacin and clarithromycin.
What limits this result
Single case report; the infection is linked to the ozone treatment by its timing. The ozone dose, volume, and technique are not reported. The abstract and the case text describe the antibiotic course differently, and the case text gives no length of follow-up and no outcome beyond resolution of the primary infection.
Harms reported after ozone therapy, and studies of how ozone exposure affects health. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Case report and review of literature
Mycobacterium abscessus mimicking tubercular spondylodiscitis following ozone therapy: A case report and review of literature
- Setting
- Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India (author affiliation)
- Read from
- Read from the full text of the paper. Read on October 2, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| Single patient | Not reported | Fluoroscopically guided percutaneous ozone treatment for degenerated disc disease at L4-L5 |
Source: Abstract on PubMed
What it measured
- Presentation three months after the ozone treatment
- Severe back pain (VAS 9/10), bilateral lower extremity radiculopathy (leg VAS 7/10), and a partial right-sided foot drop
- Inflammatory markers
- CRP 27 mg/dl and ESR 58 mm/h, both elevated
The C-reactive protein (CRP 27 mg/dl) and erythrocyte sedimentation rate (ESR 58 mm/h) rates were both elevated
- Repeat lumbar MRI
- L4-L5 spondylodiscitis with paradiscal erosion consistent with a tubercular type of infection
- Culture of epidural material taken at surgery
- Mycobacterium abscessus cultured from the epidural purulent material
- Return after 6 weeks
- Fluid collection in the wound; CRP and ESR still elevated
- Treatment after wound debridement
- Intravenous amikacin 500 mg twice daily for 6 weeks with oral clarithromycin 500 mg twice daily
The wound was debrided and then she was discharged on intravenous amikacin 500 mg (intravenously) twice daily for 6 weeks, supplemented with oral clarithromycin 500 mg twice daily.
- Later course
- Oral clarithromycin continued for another 6 weeks after resolution of the primary infection
- Literature review
- 10 earlier cases of vertebral osteomyelitis attributed to M. abscessus reviewed
Safety as reported
L4-L5 spondylodiscitis caused by Mycobacterium abscessus following ozone therapy, which the authors call a noncondoned method of lumbar disc management
Source: Abstract on PubMed
Funding and conflicts
No conflicts of interest declared
Source: Full text on PubMed Central
Where we cite this study
Does EBO2 (EBOO) Work? The Evidence, Study by Study
Every study in our EBO2 (EBOO) library in one place: design, size, what was measured and found, its limits, and a check for any study a clinic cites.
Ozone Therapy Adverse Events by Route: What Case Reports Show, and Where EBO2 (EBOO) Fits
Every ozone therapy adverse event we could read in case reports and series, grouped by route, plus how to search FDA's MAUDE data and report to MedWatch.