Tuberculous Spondylitis in a Hemodialysis Patient.
- Author:
Hyei Young YOU
1
;
Young Shin SHIN
;
Young Sik WOO
;
Gang Heun CHE
;
Jung Rock LEE
;
So Young LEE
;
Cheol Whee PARK
;
Myoug Im AHN
;
Hoon Sik CHANG
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine,The Catholic University of Korea, Seoul, Korea. ysshin@vincent.cuk.ac.kr
- Publication Type:Case Report
- Keywords:
End stage renal disease;
Tuberculous spondylitis;
Anti Tuberculosis medication;
Radical excision surgery
- MeSH:
Acidosis;
Back Pain;
Diagnosis;
Dialysis;
Female;
Fever;
Humans;
Immunity, Cellular;
Kidney Failure, Chronic;
Magnetic Resonance Imaging;
Malnutrition;
Middle Aged;
Renal Dialysis*;
Rifampin;
Spine;
Spondylitis*;
Tomography, X-Ray Computed;
Tuberculosis;
Uremia;
Weight Loss
- From:Korean Journal of Nephrology
2001;20(6):1075-1079
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Patients undergoing maintenance dialysis show an increased susceptibility to tuberculosis because host immunity is decreased secondary to malnutrition, impaired cellular immunity, acidosis and etc. Extrapulmonary tuberculosis is more prevalent in patients with end stage renal disease than in normal subjects. Among the extrapulmonary tuberculosis in patients receiving hemodialysis, the diagnosis of tuberculous spondylitis is difficult because the symptoms are non specific and attributable to uremia, and the appearance of plain radiographs is often normal during the early phase of the disease. We experienced a case of tuberculous spondylitis in a hemodialysis patient. A 55 years old female admitted with fever, weight loss and back pain. Conventional radiograph of T-spine showed no definite abnormal finding. However, chest CT revealed heterogeneously enhancing soft tissue around the T8 vertebral body and T-spine MRI showed compatible finding to tuberculous spondylitis. She received radical excision of involved vertebra and confirmed tuberculous spondylitis with histologic finding from a surgical specimen. Following the administration of anti-tuberculosis medication(isoniazid, rifampin, pyraziamide, ethambutol) and radical excision, patient's symptom and sign were improved. The patient is maintaining dialysis with anti-tuberculosis medication for 5 months.
