spinal tuberculosis

Summary

Summary: Osteitis or caries of the vertebrae, usually occurring as a complication of tuberculosis of the lungs.

Top Publications

  1. Nene A, Bhojraj S. Results of nonsurgical treatment of thoracic spinal tuberculosis in adults. Spine J. 2005;5:79-84 pubmed
    The indications for surgery in spinal tuberculosis have been controversial, and more so recently, in the era of renewed understanding of the concept of multi-drug-resistant tuberculosis along with newer modalities of spinal ..
  2. Jin D, Qu D, Chen J, Zhang H. One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis. Eur Spine J. 2004;13:114-21 pubmed
    There are few articles in the literature concerning anterior instrumentation in the surgical management of spinal tuberculosis in the exudative stage...
  3. Chen Y, Chang M, Wang S, Yu W, Liu C, Chen T. One-stage posterior surgery for treatment of advanced spinal tuberculosis. J Chin Med Assoc. 2003;66:411-7 pubmed
    It is not uncommon that some patients in poor general condition and advanced spinal tuberculosis cannot proceed with the staged anterior spinal surgery after posterior instrumentation...
  4. Deng Y, Lv G, An H. En bloc spondylectomy for the treatment of spinal tuberculosis with fixed and sharply angulated kyphotic deformity. Spine (Phila Pa 1976). 2009;34:2140-6 pubmed publisher
    Thirty-four patients having advanced spinal tuberculosis with angulated kyphotic deformity who underwent posterior en bloc spondylectomy were reviewed.
  5. Ge Z, Wang Z, Wei M. Measurement of the concentration of three antituberculosis drugs in the focus of spinal tuberculosis. Eur Spine J. 2008;17:1482-7 pubmed publisher
    ..of antituberculosis drugs such as rifampin, isoniazid, and pyrazinamide in pathologic vertebrae of spinal tuberculosis in order to provide the regimen of chemotherapy and surgical treatment of spinal tuberculosis...
  6. Guo L, Ma Y, Chen X, Bao D, Luo X. [Clinical study of short-course chemotherapy combined with radical operation in retreating spinal tuberculosis]. Zhongguo Gu Shang. 2010;23:491-4 pubmed
    To investigate clinical outcome of short-course chemotherapy in retreating spinal tuberculosis after radical operation.
  7. Jain A, Aggarwal P, Arora A, Singh S. Behaviour of the kyphotic angle in spinal tuberculosis. Int Orthop. 2004;28:110-4 pubmed
    We followed 70 adult patients with spinal tuberculosis for a minimum of 2 years...
  8. van Well G, van der Mark L, Vermeulen R, Van Royen B, Wuisman P, van Furth A. Spinal tuberculosis in a 14-year-old immigrant in the Netherlands. Eur J Pediatr. 2007;166:1071-3 pubmed
    ..due to vertebral granulomatous necrosis, needing immediate decompression and later stabilizing and reconstructive orthopaedic surgery, in order to create awareness for TB in general, especially this forgotten form of spinal tuberculosis.
  9. Moorthy S, Prabhu N. Spectrum of MR imaging findings in spinal tuberculosis. AJR Am J Roentgenol. 2002;179:979-83 pubmed

More Information

Publications69

  1. Oguz E, Sehirlioglu A, Altinmakas M, Ozturk C, Komurcu M, Solakoglu C, et al. A new classification and guide for surgical treatment of spinal tuberculosis. Int Orthop. 2008;32:127-33 pubmed
    ..system based on objective findings that can serve as a guide in selecting the treatment method for spinal tuberculosis. This retrospective study evaluates patients with spinal tuberculosis (Pott's disease) treated with ..
  2. Park D, Sohn J, Kim E, Cho D, Lee J, Kim K, et al. Outcome and management of spinal tuberculosis according to the severity of disease: a retrospective study of 137 adult patients at Korean teaching hospitals. Spine (Phila Pa 1976). 2007;32:E130-5 pubmed
    A retrospective study examining the clinical features, management, and treatment outcome of patients with spinal tuberculosis (TB).
  3. Jain A, Maheshwari A, Jena S. Kyphus correction in spinal tuberculosis. Clin Orthop Relat Res. 2007;460:117-23 pubmed
    ..paraplegia is best avoided by correcting severe kyphosis in the active, healing, or healed stages of spinal tuberculosis. We report 16 patients with dorsal or dorsolumbar spinal TB--nine with paraplegia, seven without paraplegia-..
  4. Wang Z, Ge Z, Jin W, Qiao Y, Ding H, Zhao H, et al. Treatment of spinal tuberculosis with ultrashort-course chemotherapy in conjunction with partial excision of pathologic vertebrae. Spine J. 2007;7:671-81 pubmed
    ..However, few systematic and clinical reports so far about medical treatment of spinal tuberculosis by using ultrashort-course chemotherapeutical schemes have been published in the spine-care literature.
  5. Guo L, Ma Y, Li H, Xue H, Peng W, Luo X. [Variety of ESR and C-reactive protein levels during perioperative period in spinal tuberculosis]. Zhongguo Gu Shang. 2010;23:200-2 pubmed
    To investigate the clinical significance of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in the treatment of spinal tuberculosis.
  6. Topuz K, Kutlay A, Simsek H, Colak A, Kaya S, Demircan M. Effect of hyperbaric oxygen therapy on the duration of treatment of spinal tuberculosis. J Clin Neurosci. 2009;16:1572-7 pubmed publisher
    ..therapy on the duration of antibiotic treatment and rate of radiological improvement in the management of spinal tuberculosis. We reviewed a total of 51 patients with tuberculous spondylitis of the spine who were treated by ..
  7. Khattry N, Thulkar S, Das A, Khan S, Bakhshi S. Spinal tuberculosis mimicking malignancy: atypical imaging features. Indian J Pediatr. 2007;74:297-8 pubmed
    Here is reported a 14-year-old boy with spinal tuberculosis. The imaging features were suggestive of non hodgkin's lymphoma with sparing of intervertebral disc. The atypical imaging features of spinal tuberculosis is discussed.
  8. Ramachandran S, Clifton I, Collyns T, Watson J, Pearson S. The treatment of spinal tuberculosis: a retrospective study. Int J Tuberc Lung Dis. 2005;9:541-4 pubmed
    ..A case who received 6 months of treatment in line with current British Thoracic Society (BTS) guidelines, and subsequently relapsed, prompted a survey of treatment and outcomes of spinal and other bone TB...
  9. Kumar R. Spinal tuberculosis: with reference to the children of northern India. Childs Nerv Syst. 2005;21:19-26 pubmed
    ..b>Spinal tuberculosis is the commonest form of skeletal tuberculosis...
  10. N Dri Oka D, N Dri Yoboue M, Varlet G, Haidara A, Ba Zeze V. [Spinal tuberculosis. Epidemiologic and diagnostic aspects: a study of 28 clinical observations]. Sante. 2004;14:81-4 pubmed
    To rapidly diagnose spinal tuberculosis in order to improve its prognosis.
  11. Dai L, Jiang L, Wang W, Cui Y. Single-stage anterior autogenous bone grafting and instrumentation in the surgical management of spinal tuberculosis. Spine (Phila Pa 1976). 2005;30:2342-9 pubmed
    Results of single-stage anterior autogenous bone grafting and instrumentation for spinal tuberculosis were reported.
  12. Selvaraj P, Kurian S, Chandra G, Reetha A, Charles N, Narayanan P. Vitamin D receptor gene variants of BsmI, ApaI, TaqI, and FokI polymorphisms in spinal tuberculosis. Clin Genet. 2004;65:73-6 pubmed
  13. Tanriverdi T, Kizilkilic O, Hanci M, Kaynar M, Unalan H, Oz B. Atypical intradural spinal tuberculosis: report of three cases. Spinal Cord. 2003;41:403-9 pubmed
    To report three cases of intradural spinal tuberculosis (TB) by calling attention to atypical forms of spinal TB.
  14. Emel E, Guzey F, Guzey D, Bas N, Sel B, Alatas I. Non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, lumbar and sacral segments: a case report. Eur Spine J. 2006;15:1019-24 pubmed
    There are only a few cases reported with non-contiguous spinal tuberculosis in the literature. Most of these patients have only two non-contiguous lesions, and in almost all of these cases, surgical treatment is required.
  15. Le Page L, Feydy A, Rillardon L, Dufour V, Le Henanff A, Tubach F, et al. Spinal tuberculosis: a longitudinal study with clinical, laboratory, and imaging outcomes. Semin Arthritis Rheum. 2006;36:124-9 pubmed
    To study imaging changes associated with spinal tuberculosis (ST) over time and evaluate their association with clinical and laboratory data.
  16. Talu U, Gogus A, Ozturk C, Hamzaoglu A, Domanic U. The role of posterior instrumentation and fusion after anterior radical debridement and fusion in the surgical treatment of spinal tuberculosis: experience of 127 cases. J Spinal Disord Tech. 2006;19:554-9 pubmed
    ..047). Anterior radical debridement and strut graft is the golden standard in the surgical treatment of spinal tuberculosis, but it should always be accompanied by posterior instrumentation and fusion to shorten the immobilization ..
  17. Kotil K, Alan M, Bilge T. Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study. J Neurosurg Spine. 2007;6:222-8 pubmed
    ..The aim of this study was to evaluate conservative medical management of 44 patients with Pott disease. The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated...
  18. Chunguang Z, Limin L, Rigao C, Yueming S, Hao L, Qingquan K, et al. Surgical treatment of kyphosis in children in healed stages of spinal tuberculosis. J Pediatr Orthop. 2010;30:271-6 pubmed publisher
    Very less literature focuses on the treatment of kyphosis in healed stages of spinal tuberculosis (TB), especially in children...
  19. Cormican L, Hammal R, Messenger J, Milburn H. Current difficulties in the diagnosis and management of spinal tuberculosis. Postgrad Med J. 2006;82:46-51 pubmed
    The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage...
  20. Polley P, Dunn R. Noncontiguous spinal tuberculosis: incidence and management. Eur Spine J. 2009;18:1096-101 pubmed publisher
    ..Treatment of noncontiguous tuberculosis is as for standard spinal TB cases in our unit with similar outcomes, but care needs to be taken in surgical planning as patients may have multiple areas of neurological compromise...
  21. Huang Q, Zheng C, Hu Y, Yin X, Xu H, Zhang G, et al. One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation. Int Orthop. 2009;33:1385-90 pubmed publisher
    The goal of this study was to assess the efficacy of one-stage surgical management for children with spinal tuberculosis by anterior decompression, bone grafting, posterior instrumentation, and fusion...
  22. Rajasekaran S. Buckling collapse of the spine in childhood spinal tuberculosis. Clin Orthop Relat Res. 2007;460:86-92 pubmed
    ..Children at risk for buckling collapse must be carefully watched and the spine stabilized to avoid a massive increase in deformity...
  23. Dai L, Jiang L, Wang Y, Jiang S. Chemotherapy in anterior instrumentation for spinal tuberculosis: highlighting a 9-month three-drug regimen. World Neurosurg. 2010;73:560-4 pubmed publisher
    Anterior instrumentation has been used for surgical treatment of spinal tuberculosis, but there are different regimens of antituberculous chemotherapy used in combination with surgical intervention...
  24. Aderibigbe A, Ologe F. Cervical spinal tuberculosis with tuberculous otitis media masquerading as otitis externa malignans in an elderly diabetic patient: case report. East Afr Med J. 2004;81:267-70 pubmed
    ..This case underscores the value of high index of suspicion, thorough and complete clinical evaluation in any patient with chronic symptoms and signs unresponsive to conventional treatment...
  25. Feng L, Qu D, Jin D, Chen J. [Observation of body temperature and erythrocyte sedimentation rate in spinal tuberculosis patients with anterior interbody autograft and internal fixation]. Di Yi Jun Yi Da Xue Xue Bao. 2002;22:84-5 pubmed
    ..The observation conducted in 21 cases establishes the 2 parameters as simple and reliable indicators for post-operative assessment of the patients...
  26. Joseffer S, Cooper P. Modern imaging of spinal tuberculosis. J Neurosurg Spine. 2005;2:145-50 pubmed
    b>Spinal tuberculosis (Pott disease) is uncommon in developed countries. On imaging studies diagnosis of this lesion may not be considered or it might be mistaken for pyogenic osteomyelitis...
  27. Lee S, Sung J, Park Y. Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech. 2006;19:595-602 pubmed
    ..anterior procedure, and propose single-stage posterior surgical approach, laminectomy and posterior decompression with transpedicular instrumentation as an alternative operative method for thoracic and thoracolumbar spinal tuberculosis.
  28. Ringshausen F, Tannapfel A, Nicolas V, Weber A, Duchna H, Schultze Werninghaus G, et al. A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease. Ann Clin Microbiol Antimicrob. 2009;8:32 pubmed publisher
    ..Tuberculous spondylitis (Pott's disease) is an ancient human disease. Because it is rare in high-income, tuberculosis (TB) low incidence countries, misdiagnoses occur as sufficient clinical experience is lacking...
  29. Zhao J, Lian X, Hou T, Ma H, Chen Z. Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly. Int Orthop. 2007;31:859-63 pubmed
    Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit...
  30. Rajasekaran S, Prasad Shetty A, Dheenadhayalan J, Shashidhar Reddy J, Naresh Babu J, Kishen T. Morphological changes during growth in healed childhood spinal tuberculosis: a 15-year prospective study of 61 children treated with ambulatory chemotherapy. J Pediatr Orthop. 2006;26:716-24 pubmed
    ..A retrospective clinical study for prognostic purposes...
  31. Dusmet M, Halkic N, Corpataux J. Video-assisted thoracic surgery diagnosis of thoracic spinal tuberculosis. Chest. 1999;116:1471-2 pubmed
    ..We propose a minimally invasive diagnostic approach that ensures that adequate surgical specimens are obtained prior to initiating treatment...
  32. Francis I, Das D, Luthra U, Sheikh Z, Sheikh M, Bashir M. Value of radiologically guided fine needle aspiration cytology (FNAC) in the diagnosis of spinal tuberculosis: a study of 29 cases. Cytopathology. 1999;10:390-401 pubmed
    ..study describes the applicability and practical aspects of the technique in establishing the diagnosis of spinal tuberculosis (TB) with the aid of radiographic guidance...
  33. Moore S, Rafii M. Imaging of musculoskeletal and spinal tuberculosis. Radiol Clin North Am. 2001;39:329-42 pubmed
    ..Maintaining reasonable suspicion and developing cognizance of the patterns of presentation allow the radiologist to diagnose efficiently the patient who presents with osteoarticular tuberculosis...
  34. Turgut M. Multifocal extensive spinal tuberculosis (Pott's disease) involving cervical, thoracic and lumbar vertebrae. Br J Neurosurg. 2001;15:142-6 pubmed
    An unusual case is reported of a 53-year-old woman presenting with spinal tuberculosis involving cervical, thoracic and lumbar vertebrae...
  35. Gopalakrishnan D, Krishna K. Cervico thoracic junction spinal tuberculosis presenting as radiculopathy. Neurol India. 2002;50:93-4 pubmed
    A case of cervico thoracic junctional area spinal tuberculosis presenting as painful radiculitis of the upper extremity is reported...
  36. Vidyasagar C, Murthy H. Spinal tuberculosis with neurological deficits. Natl Med J India. 1996;9:25-7 pubmed
    ..Conservative treatment is unwise because it is not always possible to distinguish between TB and neoplastic lesions...
  37. Upadhyay S, Sell P, Saji M, Sell B, Yau A, Leong J. 17-year prospective study of surgical management of spinal tuberculosis in children. Hong Kong operation compared with debridement surgery for short- and long-term outcome of deformity. Spine (Phila Pa 1976). 1993;18:1704-11 pubmed
    ..and long-term results of two surgical procedures, radical excision or debridement, for the management of spinal tuberculosis in children is reported...
  38. al Arabi K, al Sebai M, al Chakaki M. Evaluation of radiological investigations in spinal tuberculosis. Int Orthop. 1992;16:165-7 pubmed
    Thirty-four cases of spinal tuberculosis were investigated by plain radiography, computerised tomography and myelography followed by computerised tomography...
  39. Oga M, Arizono T, Takasita M, Sugioka Y. Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Clinical and biologic study. Spine (Phila Pa 1976). 1993;18:1890-4 pubmed
    The risk of persistence and recurrence of infection in posterior spinal instrumentation surgery for spinal tuberculosis was studied clinically and microbiologically...
  40. Guven O, Kumano K, Yalcin S, Karahan M, Tsuji S. A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine (Phila Pa 1976). 1994;19:1039-43 pubmed
    The authors employed a new mode of treatment for spinal tuberculosis consisting of single stage posterior instrumentation and fusion without anterior debridement. Ten patients were operated upon in this manner...
  41. al Sebai M, Al Khawashki H, al Arabi K, Khan F. Operative treatment of progressive deformity in spinal tuberculosis. Int Orthop. 2001;25:322-5 pubmed
    ..We consider such spines to be 'unstable' and have found that anterior as well as posterior fusion with instrumentation is necessary...
  42. Upadhyay S, Saji M, Yau A. Duration of antituberculosis chemotherapy in conjunction with radical surgery in the management of spinal tuberculosis. Spine (Phila Pa 1976). 1996;21:1898-903 pubmed
    ..One hundred fourteen patients were followed prospectively for a mean period of 14.6 years after radical resection of the tuberculous lesion and reconstruction of the resultant gap with bone graft...
  43. Arthornthurasook A, Chongpieboonpatana A. Spinal tuberculosis with posterior element involvement. Spine (Phila Pa 1976). 1990;15:191-4 pubmed
    ..The cold abscess extended dorsally, reaching the surface in three patients. All surgical specimens were confirmed as tuberculous infection by histologic examination...
  44. Pertuiset E, Beaudreuil J, Liote F, Horusitzky A, Kemiche F, Richette P, et al. Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980-1994. Medicine (Baltimore). 1999;78:309-20 pubmed
    b>Spinal tuberculosis (TB) accounts for about 2% of all cases of TB. New methods of diagnosis such as magnetic resonance imaging (MRI) or percutaneous needle biopsy have emerged...
  45. Turgut M. Spinal tuberculosis (Pott's disease): its clinical presentation, surgical management, and outcome. A survey study on 694 patients. Neurosurg Rev. 2001;24:8-13 pubmed
    ..In the present study, it was concluded that the neurological involvement due to Pott's disease is relatively benign if urgent decompression is performed at the onset of the disease...
  46. Yilmaz C, Selek H, Gurkan I, Erdemli B, Korkusuz Z. Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am. 1999;81:1261-7 pubmed
    Kyphosis and neurological impairment are the major residual problems of spinal tuberculosis after the microorganism has been eradicated with use of appropriate medications...
  47. Józsa L, Farkas G. [Cripples at the medieval hospital of Bátmonostor, Hungary--archeological findings]. Orv Hetil. 2006;147:2379-84 pubmed
    ..Paleopathologic study of the physically disabled may yield information and insight on the prevalence of crippling disorders. The authors hypothetize, that crippled persons lived in the hospital until their deaths. ..
  48. Guzey F, Emel E, Bas N, Hacisalihoglu S, Seyithanoglu M, Karacor S, et al. Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases. J Neurosurg Spine. 2005;3:450-8 pubmed
    ..This procedure is associated with easy access to the spinal canal for neural decompression, prevention of loss of corrected vertebral alignment in the long term, and facilitation of early mobilization. ..
  49. Azam M, Bhatti N. Intracranial tuberculomas and caries spine: an experience from Children's Hospital Islamabad. J Ayub Med Coll Abbottabad. 2004;16:7-11 pubmed
    ..One child with cerebral tuberculomas died. Intracranial tuberculomas and spinal tuberculosis are not rare problems in children...
  50. Zhang H, Guo C, Xiao X, Long W, Deng Z, Chen J. One-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region by anterior decompression, strut autografting, posterior instrumentation, and fusion. J Spinal Disord Tech. 2007;20:263-7 pubmed
    ..Many reports have documented a good clinical efficacy of surgical management for spinal tuberculosis. However, how to deal with MTSUTR is rarely reported in the literature...
  51. di Martino L, Tomasi L, Bernaudo F, Leone E, Pisanti A, Rufolo L. [Tubercular spondylodiscitis with multiple abscesses in a teenager: clinical and diagnostic considerations]. Infez Med. 2001;9:111-4 pubmed
    ..We reaffirm, for early and accurate diagnosis, the importance of abdominal echography and spinal tomography. ..
  52. Taylor G, Murphy E, Hopkins R, Rutland P, Chistov Y. First report of Mycobacterium bovis DNA in human remains from the Iron Age. Microbiology. 2007;153:1243-9 pubmed
    ..Moreover, it shows that loss of DNA from RD4, which defines classic M. bovis, had already occurred from the genome over 2000 years before the present. ..
  53. Collazos J, Quintas L, Mayo J. Tuberculous esophageal ulcer as the mode of presentation of Pott's disease (tuberculous spondylitis). Am J Med. 2002;112:737-9 pubmed
  54. Wasay M, Arif H, Khealani B, Ahsan H. Neuroimaging of tuberculous myelitis: analysis of ten cases and review of literature. J Neuroimaging. 2006;16:197-205 pubmed
    ..MRI findings in patients with spinal cord tuberculosis have both diagnostic and prognostic significance. Cord atrophy or cavitation and the presence of syrinx on MRI may be associated with poor outcome...
  55. Ptaszynski A, Hooten W, Huntoon M. The incidence of spontaneous epidural abscess in Olmsted County from 1990 through 2000: a rare cause of spinal pain. Pain Med. 2007;8:338-43 pubmed
    ..The primary objective of this study is to determine the population-based incidence of spontaneous epidural abscess. The secondary objective is to characterize the clinical course of patients with this rare infectious disease...
  56. Korres D, Papagelopoulos P, Zahos K, Kolia M, Poulakou G, Falagas M. Multifocal spinal and extra-spinal Mycobacterium chelonae osteomyelitis in a renal transplant recipient. Transpl Infect Dis. 2007;9:62-5 pubmed
    ..Long-term antimicrobial chemotherapy and surgical intervention is the cornerstone of successful treatment of multifocal bone M. chelonae infection...
  57. Ozdemir H, Us A, Ogün T. The role of anterior spinal instrumentation and allograft fibula for the treatment of pott disease. Spine (Phila Pa 1976). 2003;28:474-9 pubmed
    ..The authors retrospectively reviewed 28 patients with multilevel Pott disease who underwent anterior radical débridement, decompression, and fusion with anterior spinal instrumentation and fibular allograft replacement...
  58. Ott H, Brun Del Re C, Steinke K. [Tuberculous sepsis -- nothing really new and still a challenge!]. Rofo. 2006;178:542-4 pubmed
  59. Miyamoto J, Sasajima H, Owada K, Odake G, Mineura K. Spinal intramedullary tuberculoma requiring surgical treatment--case report. Neurol Med Chir (Tokyo). 2003;43:567-71 pubmed
    ..Surgical intervention is mandatory in patients with intramedullary tuberculoma if neurological symptoms deteriorate or lesions enlarge despite continuous antituberculous therapy...
  60. Yilmaz M, Kantarci F, Mihmanli I, Kanberoglu K. Multifocal skeletal tuberculosis. South Med J. 2004;97:785-7 pubmed
    ..Since tuberculosis can be present in multiple sites, especially in patients from areas where tuberculosis is endemic, it is essential to avoid a delay in diagnosis...