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Infliximab-related tubercular spinal epidural abscess without osseous involvement in a patient with Crohn’s disease: A case report


1 Institute of Advanced Spine Sciences, Chennai, Tamil Nadu, India
2 Department of Gastroenterology, Gleneagles Global Health City, Chennai, Tamil Nadu, India
3 Department of Infectious diseases, Gleneagles Global Health City, Chennai, Tamil Nadu, India

Correspondence Address:
Phani Kiran Surapuraju,
Gleneagles Global Health City, #439, Cheran Nagar, Sholinganallur, Medavakkam Road, Perumbakkam, Chennai, Tamil Nadu.
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/isj.isj_7_20

Tubercular spinal epidural abscess without osseous involvement is an extremely rare presentation of spinal tuberculosis. We report a case of perianal Crohn’s disease, who developed a tubercular epidural abscess in lumbosacral spine without osseous involvement, secondary to infliximab administration, despite being on 6 months of antituberculous therapy for perianal tuberculosis even as the primary focus healed well. This is probably the first case of infliximab-related tubercular spinal epidural abscess without osseous involvement. A combination of surgical treatment and antitubercular therapy gives a good outcome. This case highlights the rare and atypical nature of presentation of spinal tuberculosis in this scenario and emphasizes the importance of vigilant follow-up to prevent delayed diagnosis, due to atypical presentations following anti-tumor necrosis factor therapy.


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