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An unusual case of craniovertebral junction tuberculosis in an infant

Sudhir K Kapoor1, Akshay Tiwari, Aashish Chaudhry

  • 1Lady Hardinge Medical College and Associated Hospitals, New Delhi, India. akshay_t_2000@yahoo.com

Spine
|November 6, 2007
PubMed

Insights

This is the first reported case of infant craniovertebral junction tuberculosis causing complete quadriplegia. Prompt diagnosis and treatment led to a full recovery, highlighting the importance of high suspicion for this rare condition.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Spinal tuberculosis (TB) is increasingly recognized globally, with a rising incidence in developed nations.
  • While spinal TB is common in children and young adults, it is rare in infants.
  • Craniovertebral junction tuberculosis is an exceptionally rare form of spinal TB.

Observation:

  • An infant presented at 9 months with Grade IV (complete) quadriplegia.
  • Craniovertebral tuberculosis was suspected based on MRI findings and confirmed via fine needle aspiration cytology.
  • The infant underwent transoral debridement, conservative immobilization, and 12 months of multidrug antitubercular therapy.

Findings:

  • The infant experienced a complete recovery from quadriplegia within one year of treatment.
  • Developmental milestones were achieved appropriately for age at the one-year follow-up.

Implications:

  • Diagnosing and managing craniovertebral TB in infants presents unique challenges.
  • A high index of suspicion is critical for early diagnosis and effective treatment in this vulnerable population.
  • This case underscores the potential for successful outcomes with timely intervention in rare pediatric neurological conditions.
Abstract

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