Presentation of a rare sacral tuberculosis in an otherwise healthy patient: diagnostic challenge and review of treatment.
In the developed world, spinal tuberculosis is a rare and often overlooked cause of a spinal mass. The most common sites for vertebral tuberculosis are the lower thoracic and upper lumbar spine, while the cervical and sacral (<5%) areas are rarely infected. Magnetic Resonance Imaging has proven to be the best imaging modality to identify spinal TB while antibiotic treatment has made spinal tuberculosis a diagnostic problem instead of a therapeutic one. We present the case of a 30-year-old male who presented with the sole complaint of a two-month history of radiating lower back pain. Imaging findings included normal radiographs and a large, heterogeneously T2-enhancing lesion found to be tuberculosis. Treatment included CT-aspiration and chemotherapy. TB spondylitis is primarily treated with medical management, and surgical intervention is usually warranted only when there is an unacceptable degree of kyphosis or persistent neurological symptoms.
Ochsner Clinic Foundation, New Orleans, USA.
Gregory J
GJ
Coffman
D000328:Adult; D006801:Humans; D008297:Male; D012447:Sacrum; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000628:therapy*