Symptoms of cervical tuberculosis

Many people have not heard of cervical tuberculosis, which is also a relatively common disease. That is to say, some tuberculosis occurs in the cervical spine. This is a relatively serious disease because it will cause certain compression. If it is serious, it will cause high paraplegia. The disability rate is relatively serious. Therefore, for this disease, it is necessary to make a good diagnosis and early treatment.

Symptoms of cervical tuberculosis

1. Systemic symptoms

Patients often have symptoms of mild poisoning and autonomic nervous system dysfunction, such as general discomfort, fatigue, loss of appetite, weight loss, low fever in the afternoon, night sweats, rapid pulse rate, palpitations and irregular menstruation. If the abscess becomes mixedly infected, high fever may occur. Children may have a more obvious fever and are often irritable, do not like to play, cry when held, and scream at night. Most patients suffer from malnutrition and anemia. If the patient has pulmonary tuberculosis, he may experience cough, sputum, hemoptysis or difficulty breathing. If combined with urinary tract tuberculosis, symptoms such as frequent urination, urgency, pain when urinating and hematuria may occur.

2. Local symptoms

Mild persistent dull pain in the neck, aggravated by backward extension and after exertion, relieved by bed rest. The pain is not obvious at night and most patients can sleep well, which is different from malignant tumors. If the lesion worsens and stimulates or compresses the nerve roots, the pain may radiate to the shoulders, upper limbs, or back of the head. There is tenderness and percussion pain over the spinous process of the affected area.

3. Stiff neck

Movement in all directions is restricted, and when looking down the head the trunk rotates together. This is mostly caused by the protective spasm of the muscles around the affected vertebra after the pain. Some patients often have torticollis deformity; some patients have their heads tilted forward, their necks shortened, and they like to support their jaws with both hands to avoid aggravating pain during movement. This is also called the Rust sign. When the atlantoaxial joint is affected, the head rotation function is largely lost. Kyphosis is usually not obvious, and is mostly a flattening of the physiological curvature.

When an anterior cervical abscess forms, discomfort in the throat, changes in voice tone, and loud snoring during sleep may occur. In severe cases, breathing and swallowing difficulties may occur. A small number of patients vomit pus, dead bone fragments and cheesy substances from the mouth, which is caused by rupture of retropharyngeal abscess or retroesophageal abscess. During physical examination, abscesses can be felt in the posterior pharynx and on both sides of the neck. Fluctuant abscesses in the posterior triangle of the neck often indicate cold abscesses.

When cervical tuberculosis causes spinal cord compression, the patient may experience spastic paralysis. Those with less severe compression may experience incomplete paraplegia, movement disorders, and may also have sensory and sphincter disorders. If the compression is more severe, complete paraplegia may occur with a clear level of sensory impairment. The tendon reflexes of the limbs are hyperreflexic, and pathological reflexes such as the Babinski sign are mostly positive.