Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights.

IF 3.4 Q2 INFECTIOUS DISEASES
Dana-Georgiana Nedelea, Diana Elena Vulpe, George Viscopoleanu, Alexandru Constantin Radulescu, Alexandra Ana Mihailescu, Sebastian Gradinaru, Mihnea Orghidan, Cristian Scheau, Romica Cergan, Serban Dragosloveanu
{"title":"Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights.","authors":"Dana-Georgiana Nedelea, Diana Elena Vulpe, George Viscopoleanu, Alexandru Constantin Radulescu, Alexandra Ana Mihailescu, Sebastian Gradinaru, Mihnea Orghidan, Cristian Scheau, Romica Cergan, Serban Dragosloveanu","doi":"10.3390/idr16050080","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the intervention and subsequently experienced significant disease progression.</p><p><strong>Methods: </strong>Upon re-presentation in 2022, mild involvement of the T12-L1 vertebrae was recorded by imaging, leading to a percutaneous needle biopsy which confirmed tuberculosis. Despite undergoing anti-tuberculous therapy for one year, the follow-up in 2024 revealed extensive infection from T10 to S1, with large psoas abscesses and a pseudo-tumoral mass of the right thigh. The patient was ultimately submitted to a two-stage surgical intervention: anterior resection and reconstruction of T11-L1 with an expandable cage, followed by posterior stabilization from T8-S1.</p><p><strong>Results: </strong>Postoperative recovery was uneventful, with significant pain relief and no neurological deficits. The patient was discharged on a continued anti-tuberculous regimen and remains under close surveillance.</p><p><strong>Conclusions: </strong>This paper presents details on the challenges of diagnosis and management of severe spinal tuberculosis, with emphasis on the importance of timely intervention and multidisciplinary care.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"16 5","pages":"1005-1016"},"PeriodicalIF":3.4000,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11507176/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Disease Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/idr16050080","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the intervention and subsequently experienced significant disease progression.

Methods: Upon re-presentation in 2022, mild involvement of the T12-L1 vertebrae was recorded by imaging, leading to a percutaneous needle biopsy which confirmed tuberculosis. Despite undergoing anti-tuberculous therapy for one year, the follow-up in 2024 revealed extensive infection from T10 to S1, with large psoas abscesses and a pseudo-tumoral mass of the right thigh. The patient was ultimately submitted to a two-stage surgical intervention: anterior resection and reconstruction of T11-L1 with an expandable cage, followed by posterior stabilization from T8-S1.

Results: Postoperative recovery was uneventful, with significant pain relief and no neurological deficits. The patient was discharged on a continued anti-tuberculous regimen and remains under close surveillance.

Conclusions: This paper presents details on the challenges of diagnosis and management of severe spinal tuberculosis, with emphasis on the importance of timely intervention and multidisciplinary care.

一名年轻男性的进行性胸腰椎结核病:诊断、治疗和手术的启示。
目的:我们介绍了一例 26 岁男性胸腰部严重脊柱结核患者的病例。患者五年来背痛不断加重,最初对非处方止痛药有反应。尽管医生在2019年建议患者进行手术治疗,但患者拒绝了,随后病情出现了显著进展:2022年再次就诊时,影像学检查发现T12-L1椎体轻度受累,随后进行了经皮穿刺活检,确诊为肺结核。尽管接受了一年的抗结核治疗,但2024年的随访显示,T10至S1椎体广泛感染,并伴有腰大肌脓肿和右大腿假性肿瘤肿块。患者最终接受了两阶段手术治疗:前部切除并用可扩张骨笼重建T11-L1,然后从T8-S1进行后部稳定:术后恢复顺利,疼痛明显缓解,无神经功能障碍。患者出院后继续接受抗结核治疗,目前仍在密切观察中:本文详细介绍了严重脊柱结核的诊断和管理所面临的挑战,强调了及时干预和多学科护理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Infectious Disease Reports
Infectious Disease Reports INFECTIOUS DISEASES-
CiteScore
5.10
自引率
0.00%
发文量
82
审稿时长
11 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信