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Open Access Case report

Spontaneous atraumatic fracture of a cervical vertebra in tuberculosis: a case report

Sumit Gupta1*, Satya Ranjan Patra2 and Asmita Parihar3

Author Affiliations

1 Lady Hardinge Medical College, Pocket A 45 B Dilshad Garden, New Delhi, 110095, India

2 Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India

3 University College of Medical Sciences and G.T.B. Hospital, New Delhi, 110092, India

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Journal of Medical Case Reports 2012, 6:138  doi:10.1186/1752-1947-6-138

Published: 31 May 2012

Abstract

Introduction

Spontaneous pathological fractures of the cervical spine due to tuberculosis are rare. But with escalating incidences of atypical presentations of tubercular disease, clinicians should exercise a high index of suspicion for early diagnosis of such cases.

Case presentation

We present a case of a 50-year-old Hindu man from northern India, who complained of pain and stiffness in his neck. His radiographs showed a fracture in his second cervical vertebral body. But further investigations raised the suspicion of an infective pathology, which was corroborated by magnetic resonance imaging and fine needle aspiration cytology. His symptoms improved and the fracture healed following antitubercular chemotherapy and immobilization.

Conclusion

In endemic regions like India, clinicians should be on the lookout for atypical presentations of tuberculosis. Any suspicious lesion should be evaluated with care for clinical, radiological and laboratory evidences of the infection. The affected spine should be protected and appropriate chemotherapy should be instituted at the earliest opportunity.