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A Case of Cervical Spine Tuberculosis in an Infant
S N Singh1, Trilok C Bhatt2, Savit Kumar3
1Head of the Department and Associate Professor, Department of Radiology, INHS , Kalyani, Gandhigram Po Visakhapatnam, India .
Insights
Pediatric cervical spine tuberculosis is rare in infants. This case highlights an unusual presentation involving a single vertebral body, leading to tuberculous meningitis and hydrocephalus, with a positive outcome after early intervention.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Neurology
Background:
- Cervical spine tuberculosis is exceptionally rare in infants, often presenting with delayed diagnosis due to subtle neurological deficits.
- Imaging is critical for diagnosing spinal tuberculosis, assessing complications, and guiding treatment, though typical presentations involve the discovertebral complex.
Observation:
- This report details an infant with an unusual case of cervical spine tuberculosis affecting a single vertebral body without intervertebral disc involvement.
- The infant also developed tuberculous meningitis (TBM) and communicating hydrocephalus secondary to the spinal infection.
Findings:
- Early diagnosis and prompt medical intervention were crucial for managing this rare condition.
- The infant experienced a near-normal recovery following timely and active treatment.
Implications:
- This case underscores the importance of considering unusual presentations of spinal tuberculosis in infants, even without typical discovertebral involvement.
- Highlights the need for comprehensive diagnostic approaches, including advanced imaging, for early detection and management of pediatric spinal tuberculosis and its complications like TBM.
Abstract:
Tuberculosis of cervical spine is an extremely rare entity in infants with only few case reports available in the literature. The diagnosis is often delayed due to less dramatic effects of paraplegia or quadriplegia in an infant as compared to older paediatric population. Along with clinical and laboratory investigations, imaging plays a crucial role in defining the extent of involvement, evaluation of complications, providing suitable differential diagnosis and monitoring response to treatment. Tuberculosis typically involves the discovertebral complex while involvement of isolated vertebral body or multiple vertebrae without involving the intervertebral discs is much less common. We present such an unusual case of cervical spine tuberculosis in an infant involving a single vertebral body without adjacent intervertebral disc involvement complicated with tuberculous meningitis (TBM) and communicating hydrocephalus. The early medical intervention in this case resulted in early diagnosis, active treatment and resultant near normal recovery.
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