Septic Olecranon Bursitis Caused by Mycobacterium abscessus in a Young Adult: A Case Report

Background Septic olecranon bursitis is typically caused by Staphylococcus aureus . However, rapidly growing nontuberculous mycobacteria (RGM), such as Mycobacterium abscessus , are emerging as indolent pathogens in postoperative wounds that often elude standard 5‐day culture protocols. Case Presentation A 20‐year‐old male developed chronic right olecranon bursitis following an olecranonectomy and subsequent minor environmental trauma. Despite multiple debridements and 6 weeks of empiric daptomycin and ertapenem, the wound failed to close. MRI demonstrated extensive pathology including cellulitis, septic arthritis, and proximal olecranon osteomyelitis. Diagnosis was achieved only after surgical specimens were held for an extended 21‐day anaerobic culture at 30°C–32°C, which recovered M. abscessus . Conclusion (Clinical Implications) The patient was successfully treated with a 12‐month multidrug regimen. At 1‐year follow‐up, MRI showed near‐total resolution of osteomyelitis, and the patient returned to full duty as a firefighter with 30°–130° elbow range of motion. Clinicians must maintain high suspicion for RGM in culture‐negative chronic wounds and request extended holding periods (≥ 21) at low temperatures of 30 o C.