Spinal Tuberculosis: Uncommon but Not UnseenKawsar, Hameem I. MD, PhD*; Gopalakrishna, Kuttetoor V. MD, FACP, FIDSA*†Infectious Diseases in Clinical Practice: May 2013 - Volume 21 - Issue 3 - p 192–195 doi: 10.1097/IPC.0b013e3182699210 Case Reports Abstract Author Information Spinal tuberculosis (TB), a destructive form of extrapulmonary TB, is uncommon in the United States. It is more common among immigrants from TB-endemic countries. Typically, the infection spreads to the vertebrae from a primary site elsewhere. Spinal TB commonly presents with an insidious onset of nonspecific back pain and can be the first presenting symptom of underlying TB. Because it presents in a similar fashion to a metastatic disease, which is more common in the United States, a diagnosis of spinal TB is often delayed, resulting in long-term disability. A high clinical suspicion coupled with appropriate imaging studies helps in prompt diagnosis and the rapid institution of treatment. Anti-TB drugs are effective to treat spinal TB, but surgery is required in refractory disease, abscess formation, vertebral collapse, and/or nerve compression. We present 2 cases of spinal TB: one responded very well to medical treatment; the other required adjunct surgery. From the *Department of Internal Medicine and †Infectious Diseases, Fairview Hospital, Cleveland Clinic Hospital, Cleveland, OH. Correspondence to: Hameem I. Kawsar, MD, PhD, Department of Internal Medicine, Fairview Hospital, Cleveland, OH 44111. E-mail: email@example.com. The authors have no funding or conflicts of interest to disclose. © 2013 Lippincott Williams & Wilkins, Inc.