Espondilodiscitis tuberculosa: uso de los exámenes complementarios con una nueva perspectiva A propósito de dos casos clínicos y revisión de la literatura Tuberculous spondylodiscitis: use of complementary tests with a new perspective - A report of two cases and review of literature Caso Clínico de Interés

Arch Med Interna 37(1): 18-22 Introduction. Tuberculosis (TB) constitutes a serious health problem nowa- days. It is a reemerging disease whose main risk factor is the human immu- nodeficiency virus (HIV) infection, in which extrapulmonary forms are much more frequent than in general population. Tuberculous spondylodiscitis (TS) represents 3% of all TB infections and 35% of extrapulmonary forms. It has an insidious clinical presentation; the diagnosis is difficult requiring imageno- logic and microbiologic technics. These characteristics result in a significant diagnosis delay which impacts on patient prognosis. Materials and methods. We present two cases of TS admitted to a public hospital in Uruguay (2012- 2013) in immunocompromised patients and with epidemiological notion of contact in one of them. Results. The diagnosis was done after clinical and radiological suspicion; needle aspiration guided by computed tomography was performed. The treatment was instituted with a latency exceeding three months. Discussion and conclusions. The techniques of molecular biology and immunology are now a valuable tool for early diagnosis of this disease, shortening the initiation of treatment and reducing the rate of complications associated with it.