Background:
Postoperative infections are one of the most common complications of spine surgery. However, following a lumbar microdiscectomy, a postoperative infection involving Mycobacterium tuberculosis (MTB) is extremely rare.
Case Description:
One and half months after a L4-5 microdiscectomy, a 47-year-old immunocompromised male with hepatitis B infection presented with low back and bilateral gluteal pain. The MRI revealed a large intraspinal/paraspinal fluid collection spanning from L4 to S1 along with an anterior epidural collection at L5. The patient underwent a L4 lumbar laminectomy for abscess drainage and wound debridement. After obtaining a positive culture for MTB, four antitubercular drug therapies (ATTs) were started, that is, isoniazid (H), rifampicin (R), ethambutol (E), a. One month later, the patient had minimal pain and no residual neurological deficit.
Conclusion:
MTB infection, although rare, should be considered among the differential diagnoses of postoperative infections following lumbar spine surgery in immunocompromised patients living in areas where tuberculosis is endemic.
Background:
Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an extremely rare form of spinal tuberculosis (TB) that is believed to be due to a host’s immune reaction against the Mycobacterium protein derivatives.
Case Description:
A 25-year-old male with human immunodeficiency virus, hepatitis C virus, and disseminated TB on antitubercular therapy for the past 8 months, presented with paraplegia of 2 months duration. When the MRI spine revealed multiple peripheral rim enhancing intradural extramedullary lesions from T6 to T8 and dorsally from T10 to T11, the patient was diagnosed with IETSC. At surgery, we countered cystic lesions adherent to the dura and the spinal cord, containing a whitish material. Postoperatively, the patient showed clinical improvement in motor power and sensation.
Conclusion:
Intradural extramedullary spinal tuberculomas in patients with a history of TB and spinal cord compression, although rare, should be considered among the differential diagnoses.
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