An alcohol-acid resistant backache

Abstract

We reported the case of a Pakistani young man, illegally residing in Italy, complaining for chronic backache. X-ray was negative, while the blood test revealed neutrophilic leukocytosis and an increase in inflammation markers. Tuberculin skin test was negative. He worsened despite of repeated cycles of analgesic therapy and fluoroquinolones. After 4 months a nuclear magnetic resonance suggested tubercular (TB) spondylitis whose etiology was confirmed by ex-juvantibus criteria. It is important to take TB in account when facing an immigrant suffering from backache, coming from a highly endemic area.