title: Spinal Tuberculosis and Cold Abscess without Known Primary Disease: Case Report and Review of the Literature.
abstract: Extrapulmonary tuberculosis (TB) is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative forMycobacterium tuberculosis. The diagnosis was confirmed weeks later when cultures demonstratedMycobacterium tuberculosis. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis.
authors.affiliation: Department of Medicine, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane, Piscataway, NJ 08854, USA.
authors.forename: Rima
authors.identifier: 0000-0003-3486-3085
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA.
authors.forename: Vedavyas
authors.initials: V
authors.lastname: Gannamani
authors.affiliation: Department of Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Shay
authors.affiliation: Department of Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA.
authors.forename: David
authors.initials: D
authors.lastname: Alcid