HI All ,
This is my last try to save my father who is at present suffering from spine infection , cause of which could not be diagnosed .
Age : 66 Years ,Origin : India ,Weight : 52 kg,Height : 160 cm
Smoking Habits : Yes . He used to smoke but stopped from last 5 years.
Drinking Habits : 4-5 times in a year . Doesn't drink from past 4 years.
Health History :
Diabetic from 1999 Year.
Pulmonary TB in 2006 , which was treated with AKT drugs .
Diagnosed with heart disease in 2014.
March 2014 : He was diagnosed with heart failure . < 35 EF . Later in May 2014 , CABG was done . Till July he was OK . but after that we found a boil filled with PUS and taken to hospital . He was then taken to OT for removing his cartilage .
This infection scenario repeated for 3 times , at end total 3 cartilages was removed . Due to CT scan using contrast done in January 2015 , his kidney was injured , later had to undergo dialysis and it got revived .
THE MAJOR PROBLEM after CABG is his infection and back pain . In September 2015 , suddenly his legs got weaken and he couldn't walk since then . MRI done that time revealed spinal cord compression .
Laminectomy and stabilization was done in September 2015 , suspecting Potts disease . But his mantoux test , culture of tissue and boipsy was negative .
Multiple Myeloma test was done and it was negative .
Concerned Issues since spine surgery : Reducing HB 7.1 and High ESR 135 .
Re-imaging POST Surgery (AFTER 2 months)
Dated : 8th December 2015
Axial ,T2,T1 SE
Sagital T2,STIR , 2D Merge
Known case of patient with CKD with suspected tuberculosis/fungal infection . Status post D1-D2 laminectomy C7 to D4 Cervical Spine External fixation
The preverterbral T2 hyperintense nodular soft signals and foci extending from the C5 vertebral body inferiorly towards the upper dorsal spine. Epidural extension also seen extending from the C5 vertebral body inferiorly . Probable discal involvement seen at C5-C6,C6-C7 , D1-D2 , D3-D4 levels . Cervical cord compression seen involving lower Cervical and upper dorsal spine .
Suggest CT guided biopsy to rule out TB/Fungal/actinomyosis etiology .
When compared with previous imaging the pre,para vertebral and epidural component is increased significantly.
CT Guided biopsy was done and only 0.5 ml fluid was aspirated . As the abscess was organised , only GeneXpert was done which was negative .
WHAT will be the cause ? As doctors say radio logically and clinically it might be Spine TB . He is on AKT drugs right now . But no cultures and test proved it to be TB .
Reasons why doctors believe it to be TB is that
1. History of Pulmonary TB in 2006 .
2. Radio logically
3. Symptomatically .
PLEASE HELP .
I wish we could offer some assistance here. However, there are no medical professionals on the forum side of this site. Your father's situation is way too complex for non medical people to even begin to provide opinions. There were several comments your made that I think is very difficult to understand (ie TB) You need to discuss all of this with his doctor.
I can understand your frustration level.
-- Ron DiLauro, Spine-Health System Moderator