Microbiological diagnosis of spinal tuberculosis

Area of Science:

• Infectious Diseases
• Orthopedics
• Microbiology

Background:

• Spinal tuberculosis (Pott's disease) is a significant extrapulmonary manifestation of Mycobacterium tuberculosis.
• It is frequently underdiagnosed, particularly in developing countries, leading to delayed treatment and increased morbidity.

Purpose of the Study:

• To review the clinical features and diagnostic approaches for spinal tuberculosis.
• To highlight the importance of microbiological confirmation in diagnosis and management.

Main Methods:

• A comprehensive literature search was conducted using Medline/PubMed.
• Keywords included "spinal infection," "spinal tuberculosis infection," "microbiological diagnosis of spinal tuberculosis," and "spinal tuberculosis PCR."
• Studies lacking microbiological diagnosis were excluded; English, Spanish, and French articles were reviewed.

Main Results:

• Spinal tuberculosis is more prevalent in developing countries and often presents with delayed diagnosis, negatively impacting prognosis.
• Approximately 20-40% of patients have concurrent infections at other sites, with pulmonary involvement posing a public health risk.
• Drug resistance patterns can be altered by prior treatments, incomplete adherence, or treatment of other tuberculosis sites.

Conclusions:

• Accurate microbiological diagnosis is essential for effective spinal tuberculosis management.
• Antitubercular medical therapy is always indicated, even with surgical intervention.
• Advancements in Polymerase Chain Reaction (PCR) techniques improve diagnostic accuracy, sensitivity, and specificity for spinal tuberculosis.