Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.

Background: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10–35...

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Autores: Sikalengo, George, Ramírez, Adrià, Faini, Diana, Mwamelo, Kim, Battegay, Manuel, Jugheli, Levan, Hatz, Christoph, Reither, Klaus, Letang, Emilio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/102453
Acceso en línea:https://hdl.handle.net/2445/102453
Access Level:acceso abierto
Palabra clave:Tuberculosi
Espondiloartropaties
Tuberculosis
Spondyloarthropathies
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spelling Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.Sikalengo, GeorgeRamírez, AdriàFaini, DianaMwamelo, KimBattegay, ManuelJugheli, LevanHatz, ChristophReither, KlausLetang, EmilioTuberculosiEspondiloartropatiesTuberculosisSpondyloarthropathiesBackground: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10–35 % of EPTB cases, with vertebral osteomyelitis (Pott’s disease) representing 50 % of the cases. We present two cases of suspected Pott’s disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital. Case Presentation: Case I: A 49-year old male, HIV-1 positive, on co-formulated tenofovir disoproxil fumarate/lamivudine/efavirenz since 2009 and CD4 counts of 205 cells/μL (13 %). He presented with lower back pain and progressive lower limb weakness for two weeks prior to admission. The physical examination revealed bilateral flaccid paraplegia with reduced reflexes, but otherwise unremarkable findings. A lateral lumbar X-ray showed noticeable reduction of intervertebral space between L4 and L5, and a small calcification in the anterior longitudinal ligament between L4 and L5, being compatible with focal spondylosis deformans but inconclusive with regard to tuberculous spondylitis. An abdominal ultrasound showed normal kidneys, bladder and prostate gland. The urinalysis and complete blood counts (CBC) were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in centrifuged urine, with no resistance to rifampicin. Case II: A 76-year old female, HIV-1 negative, presented with lower back pain and progressive weakness and numbness of the lower limbs for two months prior to admission. The physical examination revealed paraplegia, but otherwise unremarkable findings. The lumbosacral X-ray findings were compatible with spondylosis deformans of the lumbar spine and possible tuberculous spondylitis in L3-L4. The abdominal and renal ultrasound showed normal kidneys and bladder. The urinalysis and CBC were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in centrifuged urine, with no resistance to rifampicin. Conclusion: We report two cases of suspected tuberculous spondylitis diagnosed through Xpert MTB/RIF in urine samples from a rural Tanzanian hospital. Urine testing using Xpert MTB/RIF reflects disseminated disease and renal involvement, and may offer a feasible additional diagnostic approach for Pott’s disease in rural Africa.BioMed Central2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/102453Articles publicats en revistes (ISGlobal)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: http://dx.doi.org/10.1186/s12879-016-1844-0BMC Infectious Diseases, 2016, vol. 16, num. 514http://dx.doi.org/10.1186/s12879-016-1844-0(c) Sikalengo et al., 2016info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1024532026-05-27T06:46:51Z
dc.title.none.fl_str_mv Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
title Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
spellingShingle Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
Sikalengo, George
Tuberculosi
Espondiloartropaties
Tuberculosis
Spondyloarthropathies
title_short Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
title_full Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
title_fullStr Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
title_full_unstemmed Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
title_sort Tuberculous spondylitis diagnosed through Xpert MTB/RIF assay in urine: a case report.
dc.creator.none.fl_str_mv Sikalengo, George
Ramírez, Adrià
Faini, Diana
Mwamelo, Kim
Battegay, Manuel
Jugheli, Levan
Hatz, Christoph
Reither, Klaus
Letang, Emilio
author Sikalengo, George
author_facet Sikalengo, George
Ramírez, Adrià
Faini, Diana
Mwamelo, Kim
Battegay, Manuel
Jugheli, Levan
Hatz, Christoph
Reither, Klaus
Letang, Emilio
author_role author
author2 Ramírez, Adrià
Faini, Diana
Mwamelo, Kim
Battegay, Manuel
Jugheli, Levan
Hatz, Christoph
Reither, Klaus
Letang, Emilio
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Tuberculosi
Espondiloartropaties
Tuberculosis
Spondyloarthropathies
topic Tuberculosi
Espondiloartropaties
Tuberculosis
Spondyloarthropathies
description Background: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10–35 % of EPTB cases, with vertebral osteomyelitis (Pott’s disease) representing 50 % of the cases. We present two cases of suspected Pott’s disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital. Case Presentation: Case I: A 49-year old male, HIV-1 positive, on co-formulated tenofovir disoproxil fumarate/lamivudine/efavirenz since 2009 and CD4 counts of 205 cells/μL (13 %). He presented with lower back pain and progressive lower limb weakness for two weeks prior to admission. The physical examination revealed bilateral flaccid paraplegia with reduced reflexes, but otherwise unremarkable findings. A lateral lumbar X-ray showed noticeable reduction of intervertebral space between L4 and L5, and a small calcification in the anterior longitudinal ligament between L4 and L5, being compatible with focal spondylosis deformans but inconclusive with regard to tuberculous spondylitis. An abdominal ultrasound showed normal kidneys, bladder and prostate gland. The urinalysis and complete blood counts (CBC) were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in centrifuged urine, with no resistance to rifampicin. Case II: A 76-year old female, HIV-1 negative, presented with lower back pain and progressive weakness and numbness of the lower limbs for two months prior to admission. The physical examination revealed paraplegia, but otherwise unremarkable findings. The lumbosacral X-ray findings were compatible with spondylosis deformans of the lumbar spine and possible tuberculous spondylitis in L3-L4. The abdominal and renal ultrasound showed normal kidneys and bladder. The urinalysis and CBC were normal. M. Tuberculosis was detected through GeneXpert MTB/RIF in centrifuged urine, with no resistance to rifampicin. Conclusion: We report two cases of suspected tuberculous spondylitis diagnosed through Xpert MTB/RIF in urine samples from a rural Tanzanian hospital. Urine testing using Xpert MTB/RIF reflects disseminated disease and renal involvement, and may offer a feasible additional diagnostic approach for Pott’s disease in rural Africa.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/102453
url https://hdl.handle.net/2445/102453
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1186/s12879-016-1844-0
BMC Infectious Diseases, 2016, vol. 16, num. 514
http://dx.doi.org/10.1186/s12879-016-1844-0
dc.rights.none.fl_str_mv (c) Sikalengo et al., 2016
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Sikalengo et al., 2016
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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