Abstract

OBJECTIVES
To review our experience of spinal tuberculosis (TB) at a major UK paediatric tertiary referral centre.
METHODS
The authors performed a retrospective case survey of 21 patients admitted to Great Ormond Street Hospital over a 15-year period (1995-2010) with confirmed or presumed spinal TB. Data were collected concerning demographics, clinical, laboratory and radiological characteristics, treatment and clinical outcome.
RESULTS
Only one patient was of Caucasian origin. Four (19%) had a previous diagnosis of TB, 11 (52%) a known contact, 10 (48%) had received BCG vaccine and none were HIV-positive. Clinical presentations included systemic symptoms (18 patients), back pain (16 patients), deformity (five patients) and neurological deficits (12 patients). Mycobacterium tuberculosis was isolated from 14 patients (67%) including one multi-drug resistant strain. Spinal cord compression or critical stenosis was demonstrated in eight patients (38%). All received TB treatment for at least 12 months; six patients received treatment for a longer period. Seven (33%) underwent surgical intervention. Seventy-five per cent showed clinical and radiological resolution after treatment. No patients died or suffered long-term neurological deficit.
CONCLUSIONS
Spinal TB in children needs a high index of suspicion for diagnosis. Early referral to an expert centre allows a multidisciplinary approach to management. The authors recommend that treatment should be individually tailored and may need to exceed 12 months in cases of poor adherence, extensive disease or drug resistance.

Links

Publisher Full Text

Authors

Eisen S, Honywood L, Shingadia D, Novelli V

Institution

Department of Infectious Diseases and Microbiology, Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK. saraheisen@hotmail.com

Source

Archives of disease in childhood 97:8 2012 Aug pg 724-9

MeSH

Adolescent
Antitubercular Agents
BCG Vaccine
Back Pain
Child
Child, Preschool
Constriction, Pathologic
Humans
Mycobacterium tuberculosis
Retrospective Studies
Risk Factors
Spinal Cord Compression
Spine
Treatment Outcome
Tuberculosis, Spinal

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22734017