CASE HISTORY – March 2015

Spinal tuberculosis. A case report

Authors: Väino Sinisalu , Ott Kiens, Jüri Hirmo, Manfred Danilovits, Lea Pehme

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A female, aged 64 years, was taken ill with low back pain in December 2013. Treatment with NSAID proved ineffective. A CT scan revealed signs of spondylodiscitis. An MRT supported the hypothesis. The patient was admitted to hospital and three-week antibacterial treatment with ceftazidime and cefepime was prescribed. Clinically, the status of the patient became worse and she was referred to the university hospital. The MRT performed six months after ictus showed destruction in L5 – S1 vertebrae. The interferon gamma releasing assay (IGRA) test was positive and antituberculosis treatment was started with isoniazid, levofloxatin, etambutol and pyrasinamide. An MRT four months after the initiation of treatment revealed positive signs: bone oedema had diminished. Clinically, low back pain became less intensive and the patient was able to walk without support. A treatment scheme has been planned for the next 12 months.