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A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease.

Abstract：

BACKGROUND:Tuberculous spondylitis (Pott's disease) is an ancient human disease. Because it is rare in high-income, tuberculosis (TB) low incidence countries, misdiagnoses occur as sufficient clinical experience is lacking. CASE PRESENTATION:We describe a fatal case of a patient with spinal TB, who was mistakenly irradiated for suspected metastatic lung cancer of the spine in the presence of a solitary pulmonary nodule of the left upper lobe. Subsequently, the patient progressed to central nervous system TB, and finally, disseminated TB before the accurate diagnosis was established. Isolation and antimycobacterial chemotherapy were initiated after an in-hospital course of approximately three months including numerous health care related contacts and procedures. CONCLUSION:The rapid diagnosis of spinal TB demands a high index of suspicion and expertise regarding the appropriate diagnostic procedures. Due to the devastating consequences of a missed diagnosis, Mycobacterium tuberculosis should be considered early in every case of spondylitis, intraspinal or paravertebral abscess. The presence of certain alarm signals like a prolonged history of progressive back pain, constitutional symptoms or pulmonary nodules on a chest radiograph, particularly in the upper lobes, may guide the clinical suspicion.

journal_name

Ann Clin Microbiol Antimicrob

journal_title

Annals of clinical microbiology and antimicrobials

authors

Ringshausen FC,Tannapfel A,Nicolas V,Weber A,Duchna HW,Schultze-Werninghaus G,Rohde G

doi

10.1186/1476-0711-8-32

subject

Has Abstract

pub_date

2009-11-20 00:00:00

pages

32

issn

1476-0711

pii

1476-0711-8-32

journal_volume

8

pub_type

杂志文章

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