Tuberculosis vertebral y compresión de la médula espinal

Autores/as

  • Tomás Zamora Bastidas Hospital Universitario San José. Popayán, Colombia
  • Luis E. Ramírez Bejarano Universidad San Martin, Cali, Colombia
  • Adalberto D. Pantoja Molina Universidad del Norte, Barranquilla, Colombia

Palabras clave:

Tuberculosis Extrapulmonar, Enfermedad de Pott, Paraplejia, Absceso Paravertebral, Extrapulmonary Tuberculosis, Pott’s Disease, Paraplegia, Paravertebral Abscess

Resumen

RESUMEN
Un tercio de la población mundial está infectada por tuberculosis. Afecta pulmones, y en el 33% otros órganos. La tuberculosis vertebral ocurre en menos del 1% de los pacientes, es más frecuente en niños. Las manifestaciones clínicas más comunes son: el dolor y la limitación funcional. En etapas avanzadas presenta una giba dorsal, y alteraciones neurológicas. Para contribuir al conocimiento de características clínicas, el hecho de ser VIH negativo y la confi rmación histopatológica que se correlacionaron con los estudios de imagen, nos lleva a difundir el caso que describimos, con excelente respuesta al tratamiento fármaco quirúrgico.

Palabras clave: Tuberculosis Extrapulmonar, Enfermedad de Pott, Paraplejia, Absceso Paravertebral.

VERTEBRAL TUBERCULOSIS AND COMPRESSION OF THE SPINAL CORD
ABSTRACT
A third of the world’s population is infected with tuberculosis. It usually affects the lungs, in 33% of the cases it affects other organs. Vertebral tuberculosis occurs in less than 1% of patients, and it more frequently affects children. The most common clinical symptoms are pain and functional limitation. In advanced stages it can cause a dorsal hump, and neurological alterations. We present the case of a 28-year old female patient with lumbar pain and gait disturbance that has evolved over a two-month period. This case had a succesful diagnosis and treatment, reported herein as a contribution to the knowledge of clinical and laboratory characteristics. This is an HIV-negative patient who was Ziehl-Nielsen positive. Pathological fi ndings correlated with imagenologic results.

Key words: Extrapulmonary Tuberculosis, Pott’s Disease, Paraplegia, Paravertebral Abscess.

Biografía del autor/a

Tomás Zamora Bastidas, Hospital Universitario San José. Popayán, Colombia

Profesor Titular. Departamento de Medicina Interna, Facultad Ciencias de la Salud. Universidad del Cauca. Hospital Universitario San José. Popayán, Colombia.

Luis E. Ramírez Bejarano, Universidad San Martin, Cali, Colombia

Médico General, Universidad San Martin, Cali, Colombia

Adalberto D. Pantoja Molina, Universidad del Norte, Barranquilla, Colombia

Médico General, Universidad del Norte, Barranquilla, Colombia

Referencias bibliográficas

REFERENCIAS

Lujan-Piedrahita M, Gonzalez Arroyave LM, Tobón

AM, Cadena J y col. Tuberculosis extrapulmonar en

una población VIH negativa. 2.004;29:59-71.

Tomás Zamora Bastidas, Luis E. Ramírez Bejarano, Adalberto D. Pantoja Molina

ISSN: 0120-5498 • MEDICINA (Bogotá) Vol. 36 No. 2 (105) Págs. 158-164 • Junio 2014

Cegielski JP, Chin DP, Espina] MA, Frieden TR,

Rodriguez R, Talbot E, et al. The global tuberculosis

situation, progress and problems in the 20th century,

prospects for the 21 st century. Inf Dis Clinics of NA

; 16: 1-58.

Mankin H. Tuberculosis of bone and joints: the Red

King lives! Curr Opin Orthop 2001; 12: 489-98.

Garcia-Lechuz JM, Julve R, Alcala L, Ruiz-Serrano

MJ, Muñoz P. Espondilodisquitis tuberculosa (Enfermedad

de Pott): experiencia en un hospital general.

Enferm Infecc Microbiol Clin 2002; 20: 5-9.

Robert M. Jasmer, M.D., Payam Nahid, M.D., and

Philip C. Hopewell, M.D.N. Latent Tuberculosis infection.

N.Engl J Med 2002; 347:1860-1866 .

Rodríguez-Gómez M, Willisch A, Fernández-Domínguez

L, López-Barros G, Garcia – Porrua C, González

- Gay MA. Tuberculosis spondylitis: epidemiologic

and clinical study in non-HIV patients from northwest

Spain. Clin Exp Rheumatol 2002; 20: 327-33.

N Demir K, Okten A, Kaymakoglu K, Dincer D, Besisik

F, Cevikbas U, et al. Tuberculous peritonitis -reports

of 26 cases, detailing diagnostic and therapeutic problems.

Eur J Gastroenterol Hepatol 2001; 13: 581-5.

Alvarez LF, Kestenger A. Tuberculosis Intestinal.

Revista Colombiana de Gastroenterología 1990;

: 43-48.

Tuli SM. Historical aspects of Pott’s disease (spinal

tuberculosis) management. Eur Spine J Off Publ

Eur Spine Soc Eur Spinal Deform Soc Eur Sect

Cerv Spine Res Soc. 2013 Jun;22 Suppl 4:529–38.

Rasouli MR, Mirkoohi M, Vaccaro AR, Yarandi KK,

Rahimi-Movaghar V. Spinal tuberculosis: diagnosis

and management. Asian Spine J. 2012 Dec;6(4):294–

Ansari S, Amanullah MF, Ahmad K, Rauniyar RK.

Pott’s Spine: Diagnostic Imaging Modalities and

Technology Advancements. North Am J Med Sci.

Jul;5(7):404–11.

Agrawal V, Patgaonkar PR, Nagariya SP. Tuberculosis

of spine. Journal of Craniovertebral Junction

and Spine. 2010; 1(14): 74 – 85

McLain RF, Isada C. Spinal tuberculosis deserves a

place on the radar screen. Cleve Clin J Med. 2004

Jul;71(7):537–49.

Ridley N, Shaikh MI, Remedios D, Mitchell R. Radiology

of skeletal tuberculosis. Orthopedics. 1998

Nov;21(11):1213–20.

Almeida A. Tuberculosis of the spine and spinal cord.

Eur J Radiol. 2005 Aug;55(2):193–201.

Jain AK, Kumar J. Tuberculosis of spine: neurological

deficit. Eur Spine J Off Publ Eur Spine Soc Eur

Spinal Deform Soc Eur Sect Cerv Spine Res Soc.

Jun;22 Suppl 4:624–33.

Gautam MP, Karki P, Rijal S, Singh R. Pott’s spine

and paraplegia. JNMA J Nepal Med Assoc. 2005

Sep;44(159):106–15.

Mbata GC, Ofondu E, Ajuonuma B, Asodike VC,

Chukwumam D. Tuberculosis of the spine (Pott’s

disease) presenting as hemiparesis. African Journal

of Respiratory Medicine. 2012; 8 (1): 18-20.

Targeted tuberculin testing and treatment of latent

tuberculosis infection. Am J Respir Crit Care

Med 2000;161:S221-S247

Menzies RI. Tuberculin skin testing. In: Reichman LB,

Hershfield ES, eds. Tuberculosis: a comprehensive

international approach. 2nd ed. New York: Marcel

Dekker, 2000:279-322.

Cormican L, Hammal R, Messenger J, Milburn HJ.

Current difficulties in the diagnosis and management

of spinal tuberculosis. Postgrad Med J. 2006

Jan;82(963):46–51

Garg RK, Somvanshi DS. Spinal tuberculosis: a

review. J Spinal Cord Med. 2011;34(5):440–54.

Handa U, Garg S, Mohan H, Garg SK. Role of fineneedle

aspiration cytology in tuberculosis of bone.

Diagn Cytopathol. 2010 Jan;38(1):1–4.

Wang D. Diagnosis of tuberculous vertebral osteomyelitis

(TVO) in a developed country and literature review.

Spinal Cord. 2005 Sep;43(9):531–42.

Huang J. et al. The Clinical outcomes of surgical

treatment of noncontiguous spinal tuberculosis: a

retrospective study in 23 cases plos one. 2014;3:936-

Sahur, et al. Espinal cord tuberculosis: a paradoxical

response to antituberculous therapy 2014. BMJ case

Rep marzo 6.

Cómo citar

[1]
Zamora Bastidas, T. et al. 2014. Tuberculosis vertebral y compresión de la médula espinal. Medicina. 36, 2 (sep. 2014), 158–164.

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Publicado

2014-09-17