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Title of Journal: Eur Spine J

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Abbravation: European Spine Journal

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Springer Berlin Heidelberg

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10.1007/bf02124513

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1432-0932

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A large tuberculosis abscess causing spinal cord c

Authors: S R Manoharan J Leitao P Emberton N A Quraishi
Publish Date: 2013/04/20
Volume: 22, Issue: 7, Pages: 1459-1463
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Abstract

An 11yearold female who is an immigrant to the UK from Afghanistan presented to our clinic with a 10day history of difficulty in walking with an unsteady gait and 3month history of progressive weakness in both her arms the right side more affected than the left Her immunisation history was unclear Examination of the arms showed bilateral thenar and hypothenar wasting more so on the right than the left An MRI scan revealed a large paraspinal abscess extending from C3/4 to T4/5 with a significant anterior epidural cord compression from C5/6 to T2/3 Therapeutic/diagnostic aspiration was performed under ultrasound guidance and the aspirate was sent for microbiology She was started empirically on multidrug antitubercular treatment and steroids Although Ziehl–Neelsen stain was negative for acidfast bacilli microbiological confirmation of TB was obtained by positive TB culture sensitive to all firstline antiTB drugs She made a dramatic improvement within 3 weeks of antitubercular treatment A followup MRI scan at 8 months showed complete resolution of the abscess At 2 years of followup she was a healthy looking child back to her school with no residual clinical signs/symptoms of the diseaseOur case of cervicothoracic tuberculous abscess in a young child suggests that even with incomplete neurological deficit caused by epidural cord compression ultrasound or CTguided aspiration and antitubercular medication provide acceptable results at 2 years of followup

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