The Use of Pleural Adenosine Deaminase in the Early Diagnosis and Treatment of Spinal Tuberculosis

被引:1
作者
Finniss, Mathew C. [1 ]
Lewis, Paul [2 ,3 ]
Patel, Paras [1 ]
机构
[1] East Tennessee State Univ, Dept Infect Dis, Quillen Coll Med, Johnson City, TN 37614 USA
[2] Johnson City Med Ctr, Pharm, Johnson City, TN USA
[3] Karius Inc, Infect Dis, Redwood City, CA USA
关键词
adenosine deaminase; tuberculous pleural effusion; afb culture; afb smear; tuberculosis spondylitis; ADA;
D O I
10.7759/cureus.23668
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Spinal tuberculosis (TB) is associated with serious neurologic morbidity. It commonly presents as back pain, with or without systemic symptoms. Magnetic resonance imaging (MRI) is the most sensitive and specific imaging modality for spinal TB. The diagnosis of spinal TB is made with tissue biopsy and acid-fast bacilli (AFB) culture; however, tissue AFB smear and tissue TB deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) can influence early clinical decision making. Ancillary tests such as the purified protein derivative (PPD) skin test, QuantiFERONs-TB Gold (QFT) or pleural adenosine deaminase (ADA) can be used in conjunction with radiology and clinical findings to initiate treatment while AFB tissue cultures are pending. Spinal TB responds well to early medical management and surgery is reserved for cases with neurologic complications.
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