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Case Reports in Infectious Diseases
Volume 2016 (2016), Article ID 1780153, 4 pages
http://dx.doi.org/10.1155/2016/1780153
Case Report

Spinal Tuberculosis and Cold Abscess without Known Primary Disease: Case Report and Review of the Literature

1Department of Medicine, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane, Piscataway, NJ 08854, USA
2Department of Medicine, Saint Peter’s University Hospital, 254 Easton Ave, New Brunswick, NJ 08901, USA

Received 15 September 2016; Revised 2 November 2016; Accepted 21 November 2016

Academic Editor: Daniela M. Cirillo

Copyright © 2016 Rima Patel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Extrapulmonary tuberculosis (TB) is uncommon but not rare. Bone and joint involvement constitute about 10% of extrapulmonary TB cases, with the spine being the most frequently affected site. Spinal TB patients typically present with back pain but other constitutional or pulmonary symptoms may be absent, rendering the diagnosis difficult. This case explores challenges in the diagnosis of spinal TB. We report a case of a 39-year-old woman presenting with vague back swelling for many years. Imaging revealed osteomyelitis of the spine but initial studies and cultures were negative for Mycobacterium tuberculosis. The diagnosis was confirmed weeks later when cultures demonstrated Mycobacterium tuberculosis. Considering the severe complications of untreated spinal TB including paraplegia and need for surgical intervention, high suspicion is critical in early diagnosis.