Abstract
A 42-year-old male complaining of thoracic spine pain was admitted to the hospital for evaluation. An X-ray and computer tomography of the thoracic spine showed spondylodiscitis of the L3 lumbar and L2-L3 intervertebral disk. The tuberculin skin test (PPD) was strongly positive. A radioscopy-guided fine needle aspirate of the affected area was cultured but did not reveal the cause of the disease. Two biopsy attempts failed to reveal the cause of the disease by culturing or by acid-fast-resistant staining (Ziehl Neelsen) of the specimens. A third biopsy also failed to detect the infectious agent by using microbiological procedures, but revealed the presence of a 245-bp amplicon characteristic of the Mycobacterium tuberculosis complex after PCR of the sample. The result demonstrates the efficacy of PCR for the identification of M. tuberculosis in situations in which conventional diagnosis by culturing techniques or direct microscopy is unable to detect the microorganism. Following this result the patient was treated with the antituberculous cocktail composed by rifampicin, pirazinamide and isoniazid during a six-month period. At the end of the treatment the dorsalgia symptoms had disappeared.
Highlights
On the basis of our experience identifying M. tuberculosis [9], we successfully applied the polymerase chain reaction (PCR) to characterize the bacteria in this clinical situation
A presumptive diagnosis of vertebral TB can be made based on patient history and/or clinical and radiological information, the final diagnosis depends on bacterial identification by culture or acidfast staining
Computer tomography of the lumbar spine confirmed the damage to L2-L3 compromising the vertebral body (Figure 1)
Summary
On the basis of our experience identifying M. tuberculosis [9], we successfully applied the polymerase chain reaction (PCR) to characterize the bacteria in this clinical situation. Diagnosis of nonpulmonary TB is often difficult; clinical findings are usually not-specific and radiological features may mimic those of other bacterial, fungal, inflammatory, and neoplastic diseases. A presumptive diagnosis of vertebral TB can be made based on patient history and/or clinical and radiological information, the final diagnosis depends on bacterial identification by culture or acidfast staining.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Brazilian Journal of Medical and Biological Research
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
