title: Tuberculous paraspinal abscess: a case of mistaken identity.
abstract: We present the case of a 35-year-old man of Pakistani origin presenting with a history suggestive of tuberculosis. Chest x-ray revealed left upper zone consolidation and mediastinal widening felt to be consistent with mediastinal lymphadenopathy. Bronchoalveolar lavage failed to yield acid-fast bacilli (AFB) and therefore CT thorax was requested with a view to surgical referral for mediastinal node biopsy. CT thorax revealed a large paravertebral abscess to be the cause of apparent mediastinal widening. CT guided biopsy confirmed Mycobacterium tuberculosis on culture. On reflection, there was preservation of the right paratracheal stripe on chest x-ray indicating that this was not mediastinal lymphadenopathy but a paravertebral mass as illustrated on CT.
authors.affiliation: Department of Cardiovascular and Respiratory Studies, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK. michael.crooks@nhs.net
authors.forename: Michael G
authors.initials: MG
authors.lastname: Crooks
authors.forename: Adam T
authors.initials: AT
authors.lastname: Hill
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010154:Pakistan / Q000208:ethnology; D011859:Radiography; D013131:Spine / Q000382:microbiology*; D014376:Tuberculosis / Q000000981:diagnostic imaging* / Q000382:microbiology; D006113:United Kingdom