11/34. Sacral tuberculosis: a case report and review of the literature.BACKGROUND: We present a patient with a heterogeneously enhancing lesion within the body of the sacrum and the sacral canal. Sacral tuberculosis (TB) was suspected because of a history of familial exposure. Few cases isolated to the sacrum have been reported in the literature. The characteristic histopathologic and magnetic resonance imaging (MRI) findings are also presented. CASE DESCRIPTION: A 31-year-old African-American male presented with an 8-month history of lower back pain radiating into his legs as well as numbness and weakness of the right foot. His history revealed PPD conversion following an exposure to active pulmonary TB 3 years prior for which he received 6 months of isoniazid prophylaxis. An MRI scan revealed a large heterogeneously enhancing lesion involving the sacrum with extension into the sacral canal. The patient underwent computed tomography (CT)- guided needle biopsy of the sacral lesion. Cytopathologic examination revealed caseating granulomas. Acid-fast bacilli cultures were positive for mycobacterium tuberculosis. He was placed on a 6-month course of isoniazid, rifampin, pyrazinamide, and ethambutol. At 3-month follow-up, his examination and symptoms had improved. CONCLUSIONS: Sacral TB is an extremely rare cause of lower back pain with radiation into the lower extremities. TB should always be considered in the differential diagnosis of isolated sacral masses, especially in light of today's increasing multidrug resistance and immunosuppressed population.- - - - - - - - - - ranking = 1keywords = back pain, back (Clic here for more details about this article) |
12/34. Brucellar spondylitis: a rare cause of spinal cord compression.STUDY DESIGN: A case report. OBJECTIVES: To present and discuss some of the difficulties in the diagnosis of brucellar spondylitis. SETTING: Ankara University, Ibni Sina Hospital, turkey. methods: We report a patient with paraplegia, misdiagnosed as having a malignancy or tuberculosis who actually suffered from brucellar spondylitis. Diagnosis was established by her history and a compatible clinical picture together with a standard tube agglutination (Wright test) titer of > or =1/160 of antibodies for brucellosis. The patient was treated with oral doxycycline, rifampicin, and ciprofloxacin combination. RESULTS: At the end of the treatment, the blood brucella Wright and anti-human globulin T titer levels decreased. Her lower limb weakness improved. She could walk, and climb stairs with the help of a cane. urinary retention and fecal incontinence also resolved. CONCLUSION: brucellosis is a systemic infection involving the musculoskeletal and nervous systems. spondylitis frequently occurs in elderly patients. An early diagnosis of brucellar spondylitis can often be difficult. In endemic regions, as in the case of our country, brucellar spondylitis should always be considered in the differential diagnosis of older patients with back pain and constitutional symptoms. An early diagnosis will help to prevent the development of more severe complications such as spinal cord compression.- - - - - - - - - - ranking = 0.5keywords = back pain, back (Clic here for more details about this article) |
13/34. Multidrug resistant miliary tuberculosis and Pott's disease in an immunocompetent patient.In a high tuberculosis TB prevalence country, mortality due to miliary TB is not unknown but the treatment outcome in general is good. We describe a previously healthy man with miliary TB who did not respond to 2-months antituberculous therapy with 4 drugs. Persistent complaints of backache, which antedated chest symptoms, resulted in a diagnosis of Pott's disease. culture of bronchial aspirate yielded multidrug resistant mycobacterium tuberculosis that responded slowly to streptomycin, ethionamide, cycloserine, clofazimine, ofloxacin, paraaminosalicylic acid and isoniazid. The association of multidrug resistant miliary TB with Pott's disease in an immunocompetent patient is yet to be highlighted.- - - - - - - - - - ranking = 0.034382162498156keywords = back, chest (Clic here for more details about this article) |
14/34. A transsternoclavicular approach for the anterior decompression and fusion of the upper thoracic spine. Technical note.The anterior approach is commonly used to reach the upper thoracic region to achieve decompression and stabilization; however, upper thoracic lesions are difficult to treat because of the regional anatomical structures, and this approach is associated with risks of complication. The authors evaluated the advantages of using a transsternoclavicular approach to aid in treating upper thoracic lesions. The procedure and surgery-related outcomes are discussed.- - - - - - - - - - ranking = 0.010301464702872keywords = upper (Clic here for more details about this article) |
15/34. Dorsolumbar junction spinal tuberculosis in an infant: case report.The treatment of spinal tuberculosis is a challenging and controversial problem. The authors present the rare case of an 8-month-old infant with dorsolumbar junction tuberculosis. The child did not sit or stand and a hump was noted on his back. Radiological evaluations demonstrated destruction by a tuberculous abscess of the T-12 and L-1 vertebral bodies, extending into the psoas muscles and spinal canal. In addition to medical therapy, radical debridement and grafting were performed via an anterolateral approach. The follow-up period was 2 years. The difficulties in the management of spinal tuberculosis in infants are discussed.- - - - - - - - - - ranking = 0.033197415403171keywords = back (Clic here for more details about this article) |
16/34. BCG osteomyelitis as a rare cause of mediastinal tumor in a one-year-old child.A one-year-old child with BCG osteomyelitis of the upper spine is reported. The child was admitted because of viral infections of the upper respiratory tract. A lateral x-ray examination of the lung showed what was thought to be a mediastinal tumor. The preoperative diagnostic problems are discussed, because the etiology in our case was unknown until the histological report arrived. The knowledge of the complication, of osteomyelitis after vaccination, is small although the first case was published more than 40 years ago. Since then about 300 cases have been reported in the literature. The disease is seen in the first five years of life in otherwise healthy children. Most cases are localized near the epiphysis of the long bones. A localization in the spine, as described in our case, has been published only three times before. The highest frequency of BCG osteomyelitis is reported in finland and sweden with about 40 cases per 1 million vaccinations.- - - - - - - - - - ranking = 0.0029432756293919keywords = upper (Clic here for more details about this article) |
17/34. Multiple metastatic tuberculosis abscesses in a patient with Pott disease and lung tuberculosis: a case report.The incidence of tuberculosis in Western countries is rising, and continued vigilance together with an awareness of its protean manifestations is essential. Cutaneous tuberculosis is a relatively rare manifestation of the disease, accounting for only 1% of extrapulmonary cases of tuberculosis and 0.14% of all reported cases of tuberculosis. A 19-year-old male patient was admitted to our clinic with skin lesions both at the front and at the back of his body. With clinical findings, histopathology, polymerase chain reaction, PA lung graph, and computerised tomography, the patient was diagnosed with metastatic tuberculosis abscess associated with lung tuberculosis and Pott's disease. Antituberculosis drugs were administered. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasing common skin disorder.- - - - - - - - - - ranking = 0.033197415403171keywords = back (Clic here for more details about this article) |
18/34. spinal cord compression from spinal tuberculosis in a child.Tuberculosis in children most frequently involves the pulmonary system. Spinal tuberculosis is very rare and insidious in children. We present a 1-year-old girl who was brought to our clinic with complaints of a bulge on her back and weakness in the feet. She was investigated with magnetic resonance imaging and at the thoracic level which revealed vertebral destruction and para- and perispinal abscess. Computed tomography of the lungs showed tuberculous lesions. The child's mother gave a post history of recovered lung tuberculosis. Due to appearance paraparesis secondary to vertebral destruction, we removed the abscess and infected bone and reconstruction was carried out with fibular allograft anteriorly. Tuberculosis bacilli were isolated from the postoperative biopsy culture. In this study, we evaluated the methods of diagnosis and treatment of spiral tuberculosis according to the studies and publications which have been done previously.- - - - - - - - - - ranking = 0.033197415403171keywords = back (Clic here for more details about this article) |
19/34. Extension of paravertebral abscess in tuberculosis of the thoracic spine: report of two cases.Two cases of tuberculosis of the thoracic spine with extrapleural extension of paravertebral abscesses, presenting radiologically as cold abscesses away from the spine in the PA chest radiograph, are presented. The radiographic features and response to antitubercular drugs are discussed.- - - - - - - - - - ranking = 0.001184747094985keywords = chest (Clic here for more details about this article) |
20/34. Tuberculous spondylitis: a clinical analysis.Twenty-seven tuberculous spondylitis patients were reviewed. Eighteen were men and 9 were women, the average age being 52 years. The lower thoracic and lumbar spines were involved most frequently. fever, progressive pain over the involved spine and tenderness were common clinical manifestations. The neurological deficits were due to direct compression of neural structures by the inflammatory products. Elevated ESR and the Mantoux test were valuable indicators. About one-fourth of patients had coexisting pulmonary tuberculosis. Therefore, tuberculous spondylitis must be considered first in cases with progressive backache, tenderness, fever, elevated ESR and positive Mantoux test.- - - - - - - - - - ranking = 0.033197415403171keywords = back (Clic here for more details about this article) |
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