A 44 year-old man with lumbago to the buttock for months, lumbar pain progressing in coughing and changing body position which failed in analgesics management.
Ultrasound detected the #85x32mm left psoas muscle abscess with many hypoechoic foci in the upper of left psoas muscle maybe due to TB infection, and hypoechoic lesions in spinal thoracic and lumbar column.
MRI confirmed the vertebral lumbar column lesions from L2-S2 and the soft tissue inflammation of the left psoas muscle [L5-S1].
Lab data was only positive HCV. But positive with QuantiFERON-TB.
TB management of the spine has been done for 9 months. And treatment of HCV infection for 3 months. Lumbago reduced in the first month of treatment. HCV negative after 3 months. And at the 9th month, the spine lesions in recovery phase of TB treatment on Spine MRI.
QuantiFERON-TB in vitro, a ELISA technic (IGRAs) measures the adaptive immunity of T cell CD 4 and T CD 8 in releasing interferon gamma while in contact peptid of TB bacteria [sens 95.3%, spec 97.6%].