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)