Tuberculosis is a chronic disease that is the leading cause of infectious disease deaths worldwide. In developed countries, incidences are minimal </span></span><span style="font-family:Verdana;&qu...Tuberculosis is a chronic disease that is the leading cause of infectious disease deaths worldwide. In developed countries, incidences are minimal </span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">however</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> complicated manifestations of tuberculosis are becoming a trend within </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the prison system. This case report illustrates a patient within the United</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> States correctional system who demonstrated a rare infection of tuberculosis despite absent pulmonary findings. Our Patient was a 39-year-old inmate presenting </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">with fatigue, night sweats, weight loss, and progressive dyspnea. Pulmonary</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> imaging and cultures of sputum were negative for tuberculosis. Further imaging and laboratory workups demonstrated extensive spinal infections along with intracranial lesions that were positive for tuberculosis. Neurosurgery declined operative medicine due to advancement of the disease and appropriate antibiotic therapy was immediately initiated. Tuberculosis continues to exist in de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">veloped countries with an increased emergence of complicated cases. Fur</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">thermore, incarceration dramatically increases an individual’s risk of worse infections. The clinical impact involves promoting awareness for a need to identify and prevent continued spread of disseminated infections. Therefore, further investigations of this trend in prisons are worth considering.展开更多
Pott’s paraplegia is still prevalent in this part of the world. Early onset paraplegia can be improved by timely surgical intervention under ATT cover. The disease mostly affects the thoraco-lumbar spine. Classically...Pott’s paraplegia is still prevalent in this part of the world. Early onset paraplegia can be improved by timely surgical intervention under ATT cover. The disease mostly affects the thoraco-lumbar spine. Classically, the diseased area is addressed by anterior thoracic or thoraco-lumbar approach and after curettage of the diseased and necrotic material the anterior column is reconstructed by rib or fibular strut graft or metallic cage and supplemented by posterior instrumentation and fusion. Laminectomy, as a method of decompression, was greatly discouraged in spinal tuberculosis with compressive myelopathy except in posterior element involvement. We present a case of a 35 years old lady with Pott’s paraplegia treated by hemilaminectomy and transpedicular limited anterior decompression of the cord and pedicle screw fixation with fusion who improved vastly in terms of motor power.展开更多
文摘Tuberculosis is a chronic disease that is the leading cause of infectious disease deaths worldwide. In developed countries, incidences are minimal </span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">and </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">however</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> complicated manifestations of tuberculosis are becoming a trend within </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the prison system. This case report illustrates a patient within the United</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> States correctional system who demonstrated a rare infection of tuberculosis despite absent pulmonary findings. Our Patient was a 39-year-old inmate presenting </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">with fatigue, night sweats, weight loss, and progressive dyspnea. Pulmonary</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> imaging and cultures of sputum were negative for tuberculosis. Further imaging and laboratory workups demonstrated extensive spinal infections along with intracranial lesions that were positive for tuberculosis. Neurosurgery declined operative medicine due to advancement of the disease and appropriate antibiotic therapy was immediately initiated. Tuberculosis continues to exist in de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">veloped countries with an increased emergence of complicated cases. Fur</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">thermore, incarceration dramatically increases an individual’s risk of worse infections. The clinical impact involves promoting awareness for a need to identify and prevent continued spread of disseminated infections. Therefore, further investigations of this trend in prisons are worth considering.
文摘Pott’s paraplegia is still prevalent in this part of the world. Early onset paraplegia can be improved by timely surgical intervention under ATT cover. The disease mostly affects the thoraco-lumbar spine. Classically, the diseased area is addressed by anterior thoracic or thoraco-lumbar approach and after curettage of the diseased and necrotic material the anterior column is reconstructed by rib or fibular strut graft or metallic cage and supplemented by posterior instrumentation and fusion. Laminectomy, as a method of decompression, was greatly discouraged in spinal tuberculosis with compressive myelopathy except in posterior element involvement. We present a case of a 35 years old lady with Pott’s paraplegia treated by hemilaminectomy and transpedicular limited anterior decompression of the cord and pedicle screw fixation with fusion who improved vastly in terms of motor power.
