Paediatric Cervical Spine Tuberculosis: A Diagnostic Dilemma!

Tuberculosis (TB) is still a problem in Paediatrics practice. Diagnosis of extra-pulmonary tuberculosis in children has remained difficult despite the gains made by newer TB diagnostic investigations. We report a twelve-year-old female, with a history of neck pain, fever, headache and weakness of all the limbs. The results of TB diagnostic investigations were all negative and the child was treated for meningitis with no clinical response. However, she responded only to a therapeutic trial of anti-TB drugs with improvement of motor function of all the limbs. The child had completed 12 months anti-TB chemotherapy for extra-pulmonary tuberculosis with full recovery of all the neurological deficits. Currently she is on follow up. A high index of suspicion is needed for diagnosis and care of rare/emerging extra-pulmonary tuberculosis in childhood.