Extrapulmonary tuberculosis--three cases in the spine.

BACKGROUND

Tuberculosis is the second most common fatal infectious disease in the world. However, it is an uncommon presentation in the Australian primary care setting.

OBJECTIVE

This article describes three cases of extrapulmonary tuberculosis (EPTB) of the spine that presented to Australian general practices; discusses features that may lead the general practitioner to consider a diagnosis of EPTB; and considers the investigation options for osseous EPTB.

DISCUSSION: All three cases presented complaining of cervical, thoracic or lumbar pain of some months duration. All three patients were migrants from India who were HIV negative and who had resided in Australia for a period of 3-8 years. Two of the patients had potentially unstable conditions of the spine, meaning there was a risk of permanent neurological damage. All three patients responded to anti-tuberculosis multidrug therapy. These cases highlight the possibility of EPTB as a differential diagnosis in the presentation of back pain in selected populations.