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BMJ Case Rep. 2018 Dec 19;11(1). pii: e226098. doi: 10.1136/bcr-2018-226098.

Extrapulmonary tuberculosis: a debilitating and often neglected public health problem.

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Department of Internal Medicine, Patan Hospital, Kathmandu, Nepal.
Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.


We report a case of a 33-year-old woman from Nepal who presented to a hospital with paraplegia. She was found to have pulmonary tuberculosis (TB) with lumbar spine involvement, and bilateral psoas abscesses. She had no initial symptoms attributable to pulmonary involvement. Her delayed presentation to the hospital led to complication of TB spine, which compromised the life of this woman working as a labourer. Early diagnosis and treatment of extrapulmonary TB is essential. Awareness regarding symptoms of different forms of extrapulmonary TB and making diagnostic modalities such as CT scan, MRI or biopsy readily available through insurance schemes are some important measures to minimise the problem so that complications like paraplegia as in our patient with spinal TB can potentially be avoided.


bone and joint infections; global health; tb and other respiratory infections; tropical medicine (infectious disease)

[Indexed for MEDLINE]

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