Tuberculous spondylodiscitis. Case presentation
Abstract
Introduction: spinal tuberculosis (tuberculous spondylodiscitis or Pott's disease) is caused by the spread of the infection, from a primary pulmonary outbreak, to the spine; it mainly affects the vertebrae between the D8 and L3. Of the cases of pulmonary tuberculosis, 3 % are patients with tuberculous spondylodiscitis, whereas among cases of extrapulmonary tuberculosis 35 % present this entity.
Case presentation: a 33 year-old male patient with a four-month respiratory history –cough and expectoration (occasionally bloody striae)–, intermittent fever of 39 °C, progressive weight loss and chronic thoracolumbar pain not relieved with analgesics or anti-inflammatories. Physical examination revealed humid and hypocolored mucosae, non-infiltrated subcutaneous cellular tissue, audible vesicular murmur, crepitant and subcrepitant rales in both lungs and an exquisite pain during palpation between the D12 and L1 vertebrae. The diagnosis of tuberculous spondylodiscitis was confirmed by complementary and imaging examinations. The patient was given antituberculous treatment.
Discussion: the diagnosis of this disease is complex because its symptoms and signs are insidious and nonspecific and imaging and microbiological examinations are essential. As a rule, the diagnostic delay is usually more than three months, which negatively affects the prognosis of the disease.
Conclusions: timely diagnosis of Mycobacterium tuberculosis infection and imaging and microbiological studies are essential both to confirm the diagnostic suspicion of tuberculous spondylodiscitis and to follow the evolution of the patient.Downloads
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