General Internal Medicine, Ohta-Nishinouchi Hospital, Koriyama, Fukushima 963-8558, Japan.
J Infect Chemother. 2010 Aug;16(4):288-91. doi: 10.1007/s10156-010-0052-x. Epub 2010 Mar 16.
Craniovertebral junction tuberculosis (CVJ TB) is a rare disease, potentially causing significant neurological deficits and even death. We report on a 80-year-old woman presenting with CVJ TB without pulmonary involvement. The diagnosis was made by biopsy of the cervical lymph node showing granulomatous caseation necrosis. Despite extensive erosion of the clivus, C1, and C2, and spinal cord compression, the patient was effectively managed with antituberculous drug therapy and conservative neck stabilization. Neck pain resulting from cervical spondylosis is common in elderly people. However, even if there is no obvious pulmonary involvement, CVJ TB should be considered in the differential diagnosis, especially in patients with painful neck stiffness. The most useful method available for evaluating this region is a combination of CT scan and MRI study. CVJ TB can be managed conservatively, except for a selected few cases, regardless of the extent of bony destruction.
颅颈交界区结核（CVJ TB）是一种罕见的疾病，可能导致严重的神经功能缺损，甚至死亡。我们报告了一例 80 岁女性，表现为无肺部受累的 CVJ TB。通过对颈部淋巴结活检显示肉芽肿性干酪样坏死作出诊断。尽管斜坡、C1 和 C2 广泛侵蚀和脊髓受压，但患者通过抗结核药物治疗和保守性颈部稳定治疗得到了有效治疗。颈椎病引起的颈部疼痛在老年人中很常见。然而，即使没有明显的肺部受累，也应考虑在鉴别诊断中包括 CVJ TB，尤其是在有颈部僵硬疼痛的患者中。评估该区域最有用的方法是 CT 扫描和 MRI 检查的结合。除了少数特定病例外，无论骨质破坏程度如何，CVJ TB 都可以通过保守治疗来管理。
