Tuberculosis ineection might increase the risk f invasive candidiasis in an immmunocompetent patient / Tuberculose pode aumentar o risco de candidíase invasiva em paciente imunocompetente

Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

As infecções profundas por Candida ocorrem geralmente em pacientes imunossuprimidos. Relatamos caso raro de infecções profundas em múltiplos órgãos por Candida albicans e neuro tuberculose em homem jovem saudável. Um jovem de 19 anos de idade queixou-se de febre e lombalgia há um mês. Relatava ainda histórico de síndrome da boca escaldada. Foi diagnosticada co-infecção por Mycobacterium tuberculosis e Candida albicans em cultura do aspirado de diferentes regiões do organismo. Os sintomas melhoraram significativamente após a terapia antifúngica e antituberculosa. Este caso é apresentado para mostrar que a tuberculose pode prejudicar o sistema imune do hospedeiro e aumentar o risco de candidíase invasiva em paciente imunocompetente.

Research on advantage chooses of CT and MRI in diagnosing spine tuberculosis / 中国医学装备

Objective:To analyze manifestation of spine tuberculosis in CT and MRI, compare two kinds of techniques respectively of diagnosis advantage. Methods: Retrospective analysis of 18 cases confirmed by the surgical operation and pathology imaging of CT and MRI Material of spine tuberculosis. Results: The CT can nicely show that the bone destruction, the bone increase osteoslerosis, sequester and new-born formation and narrow of intervertebral disc, swelling paraspinal soft tissue and psoas major muscle abscess, spinal canal of bone is narrow, calcification. Although CT can show intervertebral disc involvement and terminal plate of vertebral body destruction in sagittal reconstruction, not equal to MRI sensitive, Evaluating intervertebral disc involvement and area of paraspinal soft tissue swells, changed in early days spine tuberculosis of valuation, MRI had obvious advantage. Conclusion: Combining CT and MRI can reflect the image of spine tuberculosis to learn a characteristic completely and be advantageous to diagnosing and discriminate diagnosis of spinal tuberculosis.

Tuberculose sacral em idosos: Causa incomum de dor lombar refrataria / Sacral tuberculosis in the elderly: An unusual cause of refractory low back pain

A coluna vertebral representa cerca de 50% dos casos de acometimento ósseo pela tuberculose. Entretanto, a tuberculose nacoluna sacral não é uma localização comum, mesmo em países em desenvolvimento. Objetivo: Descrever a importância dediagnóstico de tuberculose vertebral na região sacral. Métodos: Relato de caso de uma paciente de 67 anos apresentando dorlombar baixa por cerca de um ano. Resultados: Avaliação radiológica inicial foi compatível com uma lesão lítica na primeiravertebral sacral (S1), sendo realizada a biopsia da lesão, porém com resultado inconclusivo. Uma nova biopsia foi realizada eMycobacterium tuberculosis bacilli foi visualizado. A paciente foi tratada com agente anti-tuberculose apresentando resoluçãocompleta da dor. Conclusão: Apesar de raro, a tuberculose sacral deve ser considerada como diagnóstico diferencial em lesõeslíticas na região sacral...

Vertebral Tuberculosis represents about 50% of all osseous compromised in tuberculosis. However, sacral tuberculosis is rareeven in developing countries. Objective: Describe the importance of the diagnosis of vertebral tuberculosis in the sacral region.Methods: Case report of a 67 year-old woman who presented with low back pain for one year. Results: Initial radiologicalevaluation was compatible with a lytic lesion at the first sacral (S1) vertebrae on the computed tomography scan. Open surgicalbiopsy was performed, but it was inconclusive. A second procedure was performed and Mycobacterium tuberculosis bacilli werevisualized on microbiological purulent fluid analysis. A complete improvement of pain was obtained after introduction of antituberculousdrugs. Conclusion: Although rare, sacral tuberculosis should be considered as a differential diagnosis of low backpain in endemic regions...

A Case of Recurrence of Spinal Tuberculosis Treatment with Posterior Approach and Followed by Successful Anterior Fusion on the Lumbosacral Spine

In the treatment of spine tuberculosis, anterior spinal fusion has been a widely accepted procedure since Hodgson and Stock in 1956 bacause of its many advantages. Posterior approch is a simplier & safer procedure. However the destructed vertebral body can not be removes completely by this procedure. A 50 years old female patient was admitted with lumbosacral tuberculosis showing massive destruction of the L5 & S1 vertebral body and abscess formation. We initially performed a curettage and debridement by the posterior approach, combined with chemotheraphy. A anterior fusion was a more risky procedure to the patient with poor general condition, severe adhesion and long destruction of the entire L5 & upper S1 vertebral body. Occurred 35 days after first operation. Curettage and debridement were again undertaken by the posterior approach on the second operation. However 45 days late, it recurred again. Therefore, we performed the anterior fusion as the third procedure and had a successful outcome. We believe that in some cases, the advantages of posterior approach and fusion may be a pitfall and should be carefully applied in the treatment of spine tuberculosis.