Abstract
Although extrapulmonary tuberculosis (TB) is more common in patients on maintanance hemodialysis than in the general population, reports of tuberculous spondylitis are rare. We experienced a patient with tuberculous spondylitis who was successfully treated by surgical therapy.
A 39-year-old female on maintenance hemodialysis for five years was admitted to our hospital because of fever and right back pain of four months'duration. Chest X-ray tomography. CT and MRI disclosed a low density tumor and destruction of the spinal hones at T5-T6, associated with positive tuberculin test, fever, increased ESR and strongly positive CRP. Conventional anti-TB therapy with isoniacid (300mg/day), rifampicin (450mg/day) and streptomicin (0.5g twice a week) failed to improve the symptoms of tuberuculous spondilytis. Surgery was performed on the 34th hospital day. After that, fever, right back pain. ESR and CRP improved rapidly. She was discharged after 3 months of rehabilitation and returned to chronic ambulatory hemodialysis.
Tuberculous spondylitis must be considered as a possible cause of unknown fever in patients on chronic hemodialysis, hecause any delay in initiating therapy might result in a serious outcome.
