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[Tuberculosis spondylodiscitis in three older patients]
Y Schoon1, M M Samson, H J J Verhaar
1Universitair Medisch Centrum Utrecht, afd. Klinische Geriatrie, Utrecht. yschoon@elkerliek.nl
Abstract:
Three patients, two women aged 78 and 70 years, respectively, and a man aged 71 years, had back pain for months. Fever was absent. Blood parameters of infection were slightly or highly elevated. The diagnosis of spondylodiscitis was confirmed by MRI in all three patients. In one patient tuberculosis was confirmed by culture. One patient was from Turkey and the other two patients had been exposed professionally to tuberculosis. On two occasions, spondylodiscitis was complicated by compression of the spinal cord, and surgical intervention was necessary on one occasion because of neurological deficit. Initial treatment consisted of long-term bed rest and antituberculous therapy. All three patients recovered successfully. Tuberculous spondylodiscitis is a rare cause of back pain, but should be included in the differential diagnosis, particularly if there is an increased risk based on the medical history or if the patient comes from an endemic region or has an increased risk due to his or her profession.
Insights
Tuberculous spondylodiscitis, a rare cause of back pain, requires consideration in differential diagnoses. Early treatment with antituberculous therapy and rest led to successful recovery in three patients.
Area of Science:
- Infectious Diseases
- Neurology
- Radiology
Background:
- Spondylodiscitis is an infection of the vertebrae and intervertebral discs.
- Tuberculous spondylodiscitis is a rare but serious form of the condition.
Observation:
- Three patients (70-78 years) presented with chronic back pain and elevated infection markers.
- MRI confirmed spondylodiscitis; one case was culture-confirmed tuberculosis.
- Two patients had spinal cord compression, requiring surgery in one instance.
Findings:
- Tuberculosis was confirmed in one patient with a history of exposure.
- All patients received antituberculous therapy and bed rest, resulting in successful recovery.
- Risk factors included travel from endemic regions or occupational exposure.
Implications:
- Tuberculous spondylodiscitis should be considered in the differential diagnosis of back pain.
- Prompt diagnosis and treatment are crucial for favorable outcomes.
- Awareness of risk factors aids in early identification and management.