A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

Authors

  • K Thuraikumar Department of Orthopaedics Hospital Sungai Buloh, Kuala Lumpur
  • V Naveen Department of Orthopaedics Hospital Tawau, Sabah
  • Mustaqim A Department of Orthopaedics Hospital Tawau, Sabah
  • Arieff AA Department of Orthopaedics Hospital Tawau, Sabah
  • K Shri Department of Orthopaedics Hospital Lahad Datu, Sabah, Malaysia
  • ZS Oon Department of Orthopaedics Hospital Tawau, Sabah

DOI:

https://doi.org/10.31344/ijhhs.v0i0.151

Keywords:

Spinal Leprosy, Spinal Tuberculosis, Mimicking

Abstract

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.

Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.

International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

Downloads

Published

2019-12-07

How to Cite

Thuraikumar, K., Naveen, V., A, M., AA, A., Shri, K., & Oon, Z. (2019). A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis. International Journal of Human and Health Sciences (IJHHS), 33. https://doi.org/10.31344/ijhhs.v0i0.151

Issue

2019: Supplementary Issue: 2019

Section

Free Paper Presentation (Oral)

License

Authors who publish in the International Journal of Human and Health Sciences agree to the following terms that:

  1. Authors retain copyright and grant International Journal of Human and Health Sciences the right of first publication of the work.

  2. Creative Commons Licence
    Articles in International Journal of Human and Health Sciences are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.
  3. Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.