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E Hurtado Caballero, E Mercader Cidoncha, A Ruiz de la Hermosa

    Acta Gastroenterologica Latinoamericana
    |June 8, 2017
    PubMed
    Summary
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    Tuberculosis spondylodiscitis, a common spinal infection, can present with atypical symptoms like inguinal pain, mimicking hernias. Early diagnosis is crucial for effective management of this challenging condition.

    Area of Science:

    • Infectious Diseases
    • Spinal Surgery
    • Radiology

    Background:

    • Tuberculosis spondylodiscitis is a frequent cause of spinal infection globally, often affecting the thoracic and lumbar spine.
    • It typically presents with multifocal disease, paraspinal, and psoas abscesses, particularly in endemic regions and in younger individuals with prior infection.

    Observation:

    • A case of a 29-year-old female with a history of pericardial tuberculosis presented with a bilateral retroperitoneal abscess secondary to tuberculosis spondylodiscitis.
    • Initial symptoms included left inguinal pain and a palpable mass, leading to a misdiagnosis of an incarcerated inguinal hernia and planned surgery.

    Findings:

    • Intraoperative findings revealed discrepancies with the initial diagnosis, prompting a change in diagnostic and treatment strategies.

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  • The retroperitoneal abscess was confirmed to be tuberculous in origin, stemming from spondylodiscitis.
  • Implications:

    • This case highlights the diagnostic challenges posed by tuberculosis spondylodiscitis due to its low incidence and non-specific clinical presentation in non-endemic areas.
    • Delayed diagnosis and management can result from atypical presentations, emphasizing the need for increased clinical suspicion and advanced imaging for accurate identification.