Events - ISN-TTS Webinar: Spinal Tuberculosis in an HIV-Positive Post-Kidney Transplant Patient Lacking Constitutional Symptoms: A Clinical Conundrum

This webinar presents a diagnostically complex case of spinal tuberculosis in a 59-year-old HIV-positive renal transplant recipient who developed chronic back pain 13 months post-transplant, without classical constitutional symptoms such as fever or weight loss. Initial TB diagnostics, including sputum AFB and GeneXpert, were negative, but spinal MRI revealed findings consistent with Pott’s disease. Management was further complicated by immunosuppressive therapy, antiretroviral–anti-TB drug interactions, and recurrent urinary tract infections due to an indwelling ileal conduit. A tailored anti-TB regimen was initiated to minimize drug interactions, with good clinical response and preserved graft function after eight months. This case underscores the importance of maintaining a high index of suspicion for extrapulmonary TB in transplant recipients, especially in resource-limited settings, and highlights the role of MRI in early detection, as well as the complexities of managing infections in immunocompromised patients.