Abstract

PATINO MATEUS, Juan David; OREJARENA ALARCON, María Alejandra; VILLABONA ROSALES, Sergio Alberto  and  ROA VILLABONA, Andrés Felipe. Spinal tuberculosis with pleural involvement: a case report. Medicas UIS [online]. 2020, vol.33, n.3, pp.67-73.  Epub Oct 30, 2020. ISSN 0121-0319.  https://doi.org/10.18273/revmed.v33n3-2020008.

Extrapulmonary tuberculosis represents up to 25% of all cases of tuberculosis. The most frequently affected organs are lymph nodes, pleura and bone. Around 10-11% of cases of extrapulmonary tuberculosis have osteoarticular involvement and a half of them present vertebral involvement. The infection is caused by hematogenous spread of the bacillus from a primary focus to the cancellous bone of the thoracic or lumbar vertebral bodies mainly. The characteristic symptom is the chronic pain in the spine, usually in the affected site, without other concomitant symptoms or signs. The association between vertebral tuberculosis and pleural involvement without an established pulmonary focus is infrequent, it has been described in 2.5% of patients, an intrigue about its pathophysiology. Similar cases in Colombia have not been reported. This article describes a case of a young patient with a history of chronic low back pain that debuts with persistent respiratory symptoms associated with constitutional symptoms; whose Mycobacterium tuberculosis infection was proven in thoracolumbar vertebrae and pleura. This case shows an atypical natural history of the disease, in which the pathophysiological mechanism of the disease would seem to have been the direct dissemination by contiguity, and emphasizes the importance of clinical suspicion to ensure timely diagnosis and treatment. MÉD.UIS.2020;33(3): 67-73

Keywords : Tuberculosis; Tuberculosis Spinal; Tuberculosis Pleural; Mycobacterium Tuberculosis; Pott’s Disease.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )