Spinal Tuberculosis within the Vertebral Arch Mimicking a Malignant Tumor: Case Report.
Journal
Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
pubmed:
8
6
2022
medline:
10
1
2023
entrez:
7
6
2022
Statut:
ppublish
Résumé
Spinal tuberculosis is a manifestation of extrapulmonary tuberculosis. The incidence of tuberculosis is low in high-income countries; however, globally, it still remains one of the most frequent fatal infectious diseases. Because of its rarity in developed countries, spinal tuberculosis can be mistaken for malignant tumors of the spine, especially in case of an atypical radiologic manifestation and without pulmonary affection. We present the case of a 39-year-old man from South India with quickly progressing gait disturbance and hypesthesia below the Th10 level. Magnetic resonance imaging revealed an osteolytic lesion of the vertebral arch Th2 with central necrosis and compression of the spinal cord altogether highly suspicious for spinal metastasis. After surgical removal of the mass by laminectomy, the patient regained normal neurologic function. Histology revealed a severe granulomatous inflammation and DNAhybridization of polymerase chain reaction (PCR) products detected Spinal tuberculosis, even with atypical radiologic appearance, has to be considered a differential diagnosis in patients with provenance from endemic countries. A multidisciplinary diagnostic approach helps perform antimicrobial susceptibility testing to avoid delaying the start of antibiotic therapy.
Sections du résumé
BACKGROUND
BACKGROUND
Spinal tuberculosis is a manifestation of extrapulmonary tuberculosis. The incidence of tuberculosis is low in high-income countries; however, globally, it still remains one of the most frequent fatal infectious diseases. Because of its rarity in developed countries, spinal tuberculosis can be mistaken for malignant tumors of the spine, especially in case of an atypical radiologic manifestation and without pulmonary affection.
METHODS
METHODS
We present the case of a 39-year-old man from South India with quickly progressing gait disturbance and hypesthesia below the Th10 level. Magnetic resonance imaging revealed an osteolytic lesion of the vertebral arch Th2 with central necrosis and compression of the spinal cord altogether highly suspicious for spinal metastasis.
RESULTS
RESULTS
After surgical removal of the mass by laminectomy, the patient regained normal neurologic function. Histology revealed a severe granulomatous inflammation and DNAhybridization of polymerase chain reaction (PCR) products detected
CONCLUSION
CONCLUSIONS
Spinal tuberculosis, even with atypical radiologic appearance, has to be considered a differential diagnosis in patients with provenance from endemic countries. A multidisciplinary diagnostic approach helps perform antimicrobial susceptibility testing to avoid delaying the start of antibiotic therapy.
Identifiants
pubmed: 35668672
doi: 10.1055/s-0042-1746171
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-94Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
Dr. Andreas Jung reports Consulting fees from Amgen; Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Amgen, AstraZenecy, Bayer Pharmaceuticals, BMS, Biocartis, Boehringer Ingelheim, Merck KgA, Lilly, MSD, Novartis, QuIP GmbH, Roche Pharma, and Takeda; Support for attending meetings and/or travel from Amgen, AstraZeneca, Bayer Pharmaceuticals, BMS, Boehringer Ingelheim, Merck KgA, MSD, Novartis, QuIP GmbH, and Roche Pharma.