TUBERCULOUS SPONDYLITIS IN A 20 YEARS-OLD MAN WITH PULMONARY LESIONS: A CASE REPORT

Authors

  • Selly Firdausi Nuzulah Department of Pulmonology and Respiratory Medicine, Dr. Ramelan Naval Hospital, Surabaya, Indonesia
  • Rike Andy Wijaya Department of Pulmonology and Respiratory Medicine, Dr. Ramelan Naval Hospital, Surabaya, Indonesia
  • Jan Arif Kadarman Department of Pulmonology and Respiratory Medicine, Dr. Ramelan Naval Hospital, Surabaya, Indonesia

DOI:

https://doi.org/10.61841/9y2ezv21

Keywords:

Tuberculous Spondylitis, Extrapulmonary Tuberculous, Mycobacterium tuberculosis, Pott's disease

Abstract

Introduction: Tuberculosis caused by Mycobacterium tuberculosis (Acid-Fast Bacilli/AFB) the disease infects the lungs (pulmonary tuberculosis), but it can also infect other organs (extrapulmonary tuberculosis). Tuberculous spondylitis or Pott's disease is an infection of Mycobacterium tuberculosis in the vertebrae (extrapulmonary tuberculosis). The early diagnosis of tuberculous spondylitis is difficult and often confused with spinal neoplasms or other pyogenic spondylitis.
 Case presentation: Our patient admitted to Dr. Ramelan Navy Hospital Surabaya with the chief complaint of bump in the lower right back since 4 months before entering the hospital, the bump felt painful (and a Wong- Baker pain scale of 4) when coughing and when touched, lump palpable with a soft consistency and 12 cm in diameter. Patient can move their legs freely and there are no limitations on the patient's range of motion. Defecate and urinate within normal limits. This patient has demonstrated a stable deformity with severe kyphosis with a 27 sagittal angulation without any neurological deficits.
Conclusions: This report highlights to clinicians the value of a high index of suspicion and careful history taking in tuberculous spondylitis; and how a combination of nonspecific findings helped reach an early diagnosis. Because the clinical manifestations of TB spondylitis differ, various methods, including thoracolumbosacral X-ray and MRI with contrast, are required to confirm the disease. As a result, an interdisciplinary collaborative team is required to achieve optimal patient outcomes and to prevent long-term sequalae

References

Global tuberculosis report 2022. Geneva: World Health Organization; 2022 (https://www.who.int/publications/i/item /9789240061729)

Ankrah AO, Glaudemans AWJM, Maes A, et al. Tuberculosis. Semin Nucl Med2018; 48: 108–130.

Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal Tuberculosis:Current Concepts. Global Spine J. 2018 Dec;8(4 Suppl):96S-108S.

Schirmer P, Renault CA, Holodniy M. In spinal tuberculosis contagious. International J Infection Dis. 2010;14:659-66.

Rivas-Garcia A, Sarria-Estrada S, Torrents-Odin Casas- Gomila L, Franquet E. Imaging findings of Pott’s disease. Eur Spine J. 2013;22:567-78.

Kusmiati T, Narendrani HP. Pott’s Disease. Jurnal Respirasi 2016;2(3):99-109.

Chen C.H., Chen Y.M., Lee C.W., Chang Y.J., Cheng C.Y., Hung J.K. Early diagnosis of spinal tuberculosis. J. Formos. Med. Assoc. 2016;115:825–836. doi: 10.1016/j.jfma.2016.07.001.

Konstantinos A. Testing for tuberculosis. Aust Prescr. 2010; 33 (1) : 12-18

Thomas CF. Tuberculosis. In: Habermann TM, Ghosh AK (eds). Concise Textbook of Mayo Clinic Internal Medicine. CRC Press. 2012; pp: 788-96

Tsantes AG, Papadopoulos DV, Vrioni G, Sioutis S, Sapkas G, Benzakour A, Benzakour T, Angelini A, Ruggieri P, Mavrogenis AF, World Association Against Infection In Orthopedics And Trauma W A I O T Study Group On Bone And Joint Infection Definitions. Spinal Infections: An Update. Microorganisms. 2020;8(4):1-18.

Tuli SM. Historical aspects of Pott’s disease (spinal tuberculosis) management. Eur Spine J. 2013;22 Suppl 4(Suppl 4):529-38.

Esteves S, Catarino I, Lopes D, Sousa C. Spinal tuberculosis: rethinking an old disease. J Spine. 2017;6(1):358- 366.

Shanmuganathan R, Ramachandran K, Shetty AP, Kanna RM. Active tuberculosis of spine: Current updates. N Am Spine Soc J. 2023 Aug 21;16:100267.doi: 10.1016/j.xnsj.2023.100267. PMID: 37736557; PMCID: PMC10510092.

Chaudhary R, Bhatta S, Singh A, Pradhan M, Shrivastava B, Singh YI, et al. Diagnostic performance of GeneXpert MTB/RIF assay compared to conventional Mycobacterium tuberculosis culture for diagnosis of pulmonary and extrapulmonary tuberculosis, Nepal. Narra J. 2021;1(2):e33.

Downloads

Published

2024-06-14

How to Cite

Firdausi Nuzulah, S. ., Andy Wijaya, R. ., & Arif Kadarman, J. . (2024). TUBERCULOUS SPONDYLITIS IN A 20 YEARS-OLD MAN WITH PULMONARY LESIONS: A CASE REPORT. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10(6), 88-94. https://doi.org/10.61841/9y2ezv21