Mimics of Spinal Tuberculosis

Abstract

Background: The incidence of atypical clinicoradiological presentations of spinal tuberculosis (TB) is on the upsurge. Lesions that share similar features should be evaluated thoroughly. Tissue diagnosis remains the only foolproof investigation to confirm the diagnosis before initiation of treatment. Objectives: To evaluate the lesions of spine masquerading as tuberculosis Materials and Methods: We present two cases who were provisionally diagnosed with a case of tubercular spondylodiscitis based on clinicoradiological findings. After failure of response from anti-tubercular drugs, they underwent operative management for decompression of neural elements and histological confirmation of the provisional diagnosis. Results: Clinical features such as back pain, weight loss, gait abnormalities with radiology such as magnetic resonance imaging, computed tomography-guided fine-needle aspiration cytology and GeneXpert helps in the early detection and initiation of treatment of spinal TB. However, in our case, 58-year-old female and 13-year-old male presented with clinic-radiological features consistent with spinal TB. Histopathology and immunohistochemistry confirm that the first case is due to Aspergillus spinal epidural abscess and second case due to round blue cell neoplasm consistent with Ewing’s sarcoma. Conclusion: This article highlights the importance of awareness of the different clinic-radiographic features of spinal lesions, which can mimic a tuberculous spondylodiscitis. In order to avoid delayed diagnosis, clinicians must be aware of differential diagnosis from common to rare entity which may interfere with other clinical conditions.

Successful management of cervical tuberculosis and severe kyphosis using polyetheretherketone expandable cage and titanium plate: A case report

“…This outcome suggests that, in carefully selected cases, anterior plating with PEEK cages can provide sufficient stability for multi-level cervical spine reconstruction, even in the presence of infection. [18][19][20]…”