Spinal Osteoarticular Multidrug-resistant Tuberculosis (MDR/RR-TB) in a Child: A Case Report

Abstract

We report a case of a young child with multidrug-resistant tuberculosis (MDR/RR-TB) of the thoracic spine, complicated by myelopathy. Clinical assessment revealed a lower thoracic gibbus and neurological features of upper motor neuron syndrome conforming to myelopathy. Radiological evaluation revealed a marked kyphosis, contiguous T10-T11 vertebral destruction, paraspinal soft tissue collection, and intraspinal compression with cord signal changes, suggestive of spinal TB. Rapid molecular testing expedited the diagnosis of MDR/RR-TB and guided prompt treatment initiation. Although second-line drugs are the mainstay of treatment, surgery was undertaken due to marked kyphosis, spinal instability, and neurological complications in the growing spine. Although the case seems interesting, it, unfortunately, highlights multiple health system failures in developing countries, resulting in premature termination of MDR/RR-TB treatment and loss of kyphosis correction with subsequent recurrence of the kyphotic deformity.