Cervical tuberculous spondylitis associated with systemic lupus erythematosus.

Abstract

A case report of cervical tuberculous spondylitis associated with systemic lupus erythematosus (SLE). Infection is a frequent problem in SLE, especially in patients hospitalised with the complications of the disease. Tuberculous spondylitis very rarely occurs in SLE patients, and cervical involvement has not been previously reported. A 54-year-old female patient was admitted to our hospital with a complaint of neck pain radiating to her shoulder of 2 months' duration. The neurological examination was completely normal and radiological investigations revealed narrowing, angulation and destruction of the end plates of the 5th and 6th cervical vertebrae. She has received corticosteroid and colchicine treatment for the diagnosis of SLE during the last 10 years. The anterior cervical approach was used and pyogenic material was debrided from the C5-6 intervertebral space, and an otogenous bone graft with a Smith Robinson type fusion was performed. High doses of corticosteroids are implicated as a risk factor for infection in SLE patients. Early diagnosis and appropriate medical and surgical treatment, as well as increased awareness of higher susceptibility to opportunistic infections, such as tuberculous spondylitis, are keystones for decreasing morbidity and mortality in patients with SLE.