InfectionSpine - Infection

Spinal Tuberculosis

Infection
Intermediate
6 min
High Yield
tuberculosis
6:00
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Spinal Tuberculosis

Clinical Scenario

Adult presenting with back pain and suspected spinal TB

Questions & Model Answers

Q

What features on history would you like to obtain?

Q

What laboratory investigations would you order?

Q

What imaging would you order?

Q

What are the principles of management of this condition?

Q

How would you achieve your diagnosis?

Q

What tests would you ask the laboratory to conduct?

Q

Does this slide confirm your diagnosis? What antibiotics would you recommend?

Key Learning Points

  • TB spares discs (unlike pyogenic infection)
  • Anterior endplate involvement is characteristic
  • Travels via ALL and PLL
  • Quantiferon and Mantoux NOT useful for active TB
  • Lowenstein-Jensen medium is specific for TB culture
  • Ziehl-Neelsen stain identifies acid-fast bacilli
  • Standard TB treatment: RIPE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol)