Tuberculosis - C2

Case contributed by A.Prof Frank Gaillard

Presentation

Neck pain.

Patient Data

Age: Young adult
CT

A destructive process involves the C2 vertebral body and base of dens with a pathological fracture. It is associated with significant surrounding soft tissue swelling. 

MRI

A destructive process affects C2 particularly on the left with peripheral enhancement and central non-enhancement. A small amount of epidural extension is seen contacting but not compressing the cord. Prevertebral swelling. The differential is of metastasis or infection. The degree of swelling favours the later, especially in the absence of known malignancy and in this age group. 

Case Discussion

The patient went on to have a biopsy.

Microbiology

DNA amplification assay for M.tuberculosis complex (PCR):  DETECTED

Mycobacterium culture screen (MGIT bottle 15 days ): POSITIVE

Mycobacterium culture: Acid Fast Bacilli: ISOLATED

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Case information

rID: 9774
Published: 23rd May 2010
Last edited: 20th Jun 2018
Tag: tb, spine
Inclusion in quiz mode: Included

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