W K Fu1, W C Wu, F K Ip. 1. Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Abstract
STUDY DESIGN: This case report describes a middle-aged woman with concomitant tuberculosis and pyogenic infection of the cervical spine. OBJECTIVE: To describe an unusual case of concomitant tuberculosis and pyogenic infection of the cervical spine. SUMMARY OF BACKGROUND DATA: Neither tuberculosis nor pyogenic spondylitis of the cervical spine is a common disorder. This case report describes a concomitant infection of C3-C4 in an otherwise healthy patient. To the authors' knowledge, such a case has never been reported. METHODS: This 52-year-old woman had spontaneous neck pain and myelopathy. Radiologic examination revealed the presence of an epidural abscess with destruction of C3-C4 vertebral bodies. RESULTS: Anterior decompression and fusion were performed, followed by therapy with antituberculosis drugs and antibiotics. The patient completely recovered. A follow-up radiograph revealed that solid fusion had been achieved. CONCLUSION: A case of concomitant tuberculosis and pyogenic infection of the cervical spine is presented. The possibility of this differential diagnosis should be considered, especially in areas of endemic tuberculosis. Examination of biopsy samples for histologic and bacteriologic findings is important to confirm this diagnosis. Radical debridement and combination therapy are strongly recommended to treat patients with this combination of infections.
STUDY DESIGN: This case report describes a middle-aged woman with concomitant tuberculosis and pyogenic infection of the cervical spine. OBJECTIVE: To describe an unusual case of concomitant tuberculosis and pyogenic infection of the cervical spine. SUMMARY OF BACKGROUND DATA: Neither tuberculosis nor pyogenic spondylitis of the cervical spine is a common disorder. This case report describes a concomitant infection of C3-C4 in an otherwise healthy patient. To the authors' knowledge, such a case has never been reported. METHODS: This 52-year-old woman had spontaneous neck pain and myelopathy. Radiologic examination revealed the presence of an epidural abscess with destruction of C3-C4 vertebral bodies. RESULTS: Anterior decompression and fusion were performed, followed by therapy with antituberculosis drugs and antibiotics. The patient completely recovered. A follow-up radiograph revealed that solid fusion had been achieved. CONCLUSION: A case of concomitant tuberculosis and pyogenic infection of the cervical spine is presented. The possibility of this differential diagnosis should be considered, especially in areas of endemic tuberculosis. Examination of biopsy samples for histologic and bacteriologic findings is important to confirm this diagnosis. Radical debridement and combination therapy are strongly recommended to treat patients with this combination of infections.