The presenting symptoms of tuberculosis
(TB)
are varied and may include acute and chronic
pain in anatomical regions with active TB infection.
Cervical spine TB, although rare, can present
with nonspecific symptomatology emanating
from the upper cervical spine, leading providers
to overlook TB in their diagnostic approach.
This case report demonstrates the necessity of
a thorough history and physical with particular
emphasis on pertinent sociodemographic risk
factors for pain medicine clinicians to reliably
ensure accurate diagnosis and treatment. A patient
with TB of the cervical spine presented as a
referral with pain symptoms refractory to standard
pharmacologic analgesic regimens. Only with a
thorough social history, made difficult by language
and sociodemographic barriers, were we able to
direct our diagnostic approach to elucidate the
etiology, and engage the patient with the appropriate
therapy.
Key words: Tuberculosis, cervicalgia, cervical
spine, extrapulmonary tuberculosis, pregabalin,
social history