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    What causes back pain in an elderly person while on Rifampicin and Ethambutol?

Posted on Wed, 2 Aug 2017 in Brain and Spine
Question: My mother's age is above 75 years and having back pain not severe. Orthopedic doctor suspected pott's spine and suggested MRI. In MRI report conclusion is ' Erosive changes along enferior end plate of L2
vertebral body with a fluid collection in L2-L3 intervertebral disc space and left psoas muscle as descrobed--? Infective. Suggested contrast study.
Posterior disc bulges causing thecal sac and bilateral foraminal nerve roots compression at L2-L3.

My question is Is my mother really having pott's decease even she has no symptoms like fever, night sweat, weight loss or loss of appetite. On doctor's advice she is taking Rifampicin, Ethambutol and Pyranizamide since 20 days back. Pl. suggest whether she should continue medications or not?
Answered by Dr. Sudhir Kumar 7 hours later
Brief Answer:
Most likely Pott's spine.

Detailed Answer:
Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.

I have noted your mother's clinical details and MRI spine reports. Based on this, the most likely diagnosis is Pott's spine (TB of spine). The decision to start anti-TB drugs is correct, even though TB has not been proven by biopsy. The treatment can be continued and MRI spine repeated after 3 months. If there is improvement, the full course of TB medicines can be given. If there is worsening on MRI, then, a biopsy of affected area can be done.

Classical symptoms such as fever, night sweats, etc may be missing in older people.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Remy Koshy
Follow up: Dr. Sudhir Kumar 13 hours later
My mother has not started taking isoniazid because by taking it only for one week, the liver disorders shouted up and we had to stopped all medications nine months back. in the mean time cured for liver and kidney deceases. Recently LFT/KFT test was done and LFT report is ok. In kft report, creatinine is 1.14, uric acid is 8.70 and calcium total is 8.30. What do you suggest doctor? Is my mother taking sufficient medicines?
Answered by Dr. Sudhir Kumar 52 minutes later
Brief Answer:
Please consult a general physician for adequate treatment of TB.

Detailed Answer:
Thank you for getting back.

You need to follow up with a general physician or an infectious disease specialist for adequate treatment of TB infection. The dose of medicines depends on body weight. In case of side effects, the medicines would be adjusted. At least 12-18 months of anti-TB treatment is needed for complete cure of Spine TB.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Sudhir Kumar


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