PDF(Pubmed)
Abstract：
Tuberculosis (TB) is quite prevalent in developing countries, with an ever-rising incidence of extrapulmonary cases. TB of bones and joints is quite challenging to diagnose. Most spinal TB lesions localize at the thoracic and lumbar levels; cervical lesions are a rarity. Hence, most neck pains are labelled cervical spondylosis as the symptomatology of cervical spine tuberculosis (CTB) remains unclear. A 38-year-old male had long-standing neck pain for six months, not associated with any focal neurological deficit, nausea, vomiting, or blurred vision. After the initial evaluation by local practitioners, the pain was, as usual, attributed to cervical spondylosis and conservatively managed. However, his pain worsened, and he ultimately came to us with altered mental status. In reality, he had CTB, which later complicated to life-threatening disseminated TB with intracranial and pulmonary involvement, and he could only survive after prolonged ICU care. Even mild cervical pain should not be neglected and must undergo proper evaluation. We should consider CTB in the differential diagnosis of chronic neck pain, especially in countries where TB is endemic.
摘要：
结核病（TB）在发展中国家非常普遍，肺外病例的发病率不断上升。骨骼和关节的结核病诊断是相当具有挑战性的。大多数脊柱结核病变位于胸部和腰部；宫颈病变很少见。因此，大多数颈部疼痛被标记为颈椎病，因为颈椎结核（CTB）的症状尚不清楚。一名38岁的男性颈部长期疼痛六个月，与任何局灶性神经功能缺损无关，恶心,呕吐,或者视力模糊.经过当地从业者的初步评估，疼痛是，像往常一样,归于颈椎病并保守治疗。然而,他的疼痛加重了,他最终带着改变的精神状态来找我们。在现实中,他有CTB,后来并发危及生命的播散性结核病，颅内和肺部受累，他只有在长期ICU护理后才能存活.即使是轻度的颈椎疼痛也不容忽视，必须进行适当的评估。慢性颈痛的鉴别诊断应考虑CTB,特别是在结核病流行的国家。
