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Extrapulmonary tuberculosis: a debilitating and often neglected public health problem
Sudeep Adhikari1, Buddha Basnyat2
1Department of Internal Medicine, Patan Hospital, Kathmandu, Nepal.
BMJ Case Reports
|December 22, 2018
Summary
A woman developed paraplegia due to delayed diagnosis of spinal tuberculosis (TB). Early detection and treatment of extrapulmonary TB are crucial to prevent severe complications like paralysis.
Area of Science:
- Medicine
- Infectious Diseases
- Neurology
Background:
- Tuberculosis (TB) can manifest in extrapulmonary sites, including the spine.
- Extrapulmonary TB, particularly spinal TB, can lead to severe neurological complications if not diagnosed and treated promptly.
Observation:
- A 33-year-old woman presented with paraplegia.
- Imaging revealed pulmonary tuberculosis with lumbar spine involvement and bilateral psoas abscesses.
- The patient had no initial symptoms of pulmonary TB, delaying her presentation.
Findings:
- Delayed diagnosis of spinal TB led to severe complications, including paraplegia.
- The spinal TB compromised the patient's mobility and quality of life.
- Bilateral psoas abscesses were noted concurrently with spinal TB.
Implications:
- Early diagnosis and treatment of extrapulmonary TB are essential to prevent irreversible neurological damage.
- Increased awareness of diverse extrapulmonary TB presentations is needed for healthcare providers.
- Accessible diagnostic tools like CT, MRI, and biopsy, potentially covered by insurance, can improve outcomes for spinal TB patients.
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