A Case of Spinal Tuberculosis From the Middle Ages in Transylvania (Romania)

Abstract

Study Design: Case report. A C C E P T E D Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.Objective: To characterise the paleopathology presented in the skeleton of a 45-50-year-old male indicative of tuberculous spondylitis and to confirm by the detection of ancient DNA.Summary of Background Data: Tuberculosis (TB) is an infectious disease prevalent in both present and ancient human populations. The disease is primarily located within the lungs, so although characacteristic bone lesions can lead to a clear diagnosis, skeletal TB occurs in only 5-6% of TB infections, even in historical cases. In addition, the visual appearance of human skeletal remains may be influenced by the environmental conditions at the burial site.However, it is important to recognise ancient skeletal TB, because this can provide important data on the history of Mycobacterium tuberculosis and gives an unique opportunity for physicians to observe the natural outcome of the infection from the pre-antibiotic era.Methods: Paleopathological analysis was carried out using careful visual observation supported by ancient DNA analysis. Approximately 60 mg of bone powder from rib fragments was examined and DNA from the M. tuberculosis complex was detected by PCR targeting specific genetic loci of the IS6110 and IS1081 regions. Results:The skeleton is part of a human osteoarchaeological collection (n=274) from the 12th-13th century Transylvanian archaeological site of Peteni, in modern-day Romania. The individual, a 45-50-year-old male, showed gross pathology typical of tuberculous spondylitis.The paleopathological diagnosis was supported by analysis for M. tuberculosis complex ancient DNA.Conclusions: This case demonstrates that TB was present in Transylvania (Romania) during the 12-13th century and adds to the growing body of knowledge on the history of this disease.

Osteological and Biomolecular Evidence of a 7000-Year-Old Case of Hypertrophic Pulmonary Osteopathy Secondary to Tuberculosis from Neolithic Hungary

“…PCR was used to amplify any DNA from specific regions of the multicopy IS 6110 and IS 1081 regions of the M. tuberculosis complex. Amplified DNA was examined initially by agarose gel electrophoresis [45]. Subsequently, these primers were used on a Real-Time platform, to enable the detection of DNA using SYBR Green and melt analysis.…”

Vertebral Distribution of Pott's Disease of the Spine among Adult Sudanese Patients in Khartoum, Sudan

“…The disease primarily present in the lung as pulmonary TB, but it also may invade bone leading to a characteristic lesion with a clear diagnosis 9 . Pott's disease of the spine is the most common form of skeletal TB.…”

7000 year-old tuberculosis cases from Hungary – Osteological and biomolecular evidence

“…Following DNA extraction [17,18], PCR was used to amplify any DNA from specific regions of the multicopy IS6110 and IS1081 regions of the M. tuberculosis complex. Amplified DNA was examined initially by agarose gel electrophoresis and these primers were subsequently used on a Real-Time platform, to enable the detection of DNA using SYBR Green and melt analysis [19]. Sequencing was attempted after extraction of DNA from gel slices.…”