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© 1994 British Society for Rheumatology

case-report

CRYPTOCOCCAL SPONDYLITIS: SOLITARY INFECTIVE BONE LESIONS ARE NOT ALWAYS TUBERCULOUS

M. J. GLYNN*, G. DUCKWORTH*, J. A. F. RIDGE{dagger}, W. J. GRANGE* and D. D. GIBBS*

*The Royal London Hospital Whitechapel, London E1 1BB
{dagger}The Manor House Hospital London, NW11 7HX

Tuberculous spondylitis is a well-recognized cause of back pain and vertebral collapse due to infection and which must not be overlooked even if it is not the most likely diagnosis. If a patient, particularly one of Asian origin, were to present with a solitary destructive bone lesion, without evidence of myeloma or other malignancy, a trial of anti-tuberculous chemotherapy would be one therapeutic approach, even if there was no evidence of tuberculosis elsewhere. However, failure to biopsy the bone lesion and undertake the appropriate microbiology could lead to other important diagnoses being missed. This is illustrated by the case which we report below.

KEY WORDS: Cryptococcal spondylitis, Infective destructive vertebral lesions


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