Back Pain and Night Sweats Led to Rare Spinal Tuberculosis Diagnosis, Case Report Shows

The case, shared by the NEJM, centres on a woman who had lived with gradually worsening low back pain for six years before receiving her diagnosis. When examined, she had a sharp, angular curve in the lower spine — a deformity doctors call kyphosis — which had developed as the infection took hold of the vertebrae.

The NEJM published the case under its *Images in Clinical Medicine* series, which highlights unusual or instructive presentations to help clinicians recognise conditions they may rarely encounter.

Spinal tuberculosis — sometimes called Pott’s disease — occurs when the bacterium that causes TB spreads from the lungs or elsewhere in the body to the bones of the spine. It can destroy the vertebrae from within, causing the spine to collapse forward into that characteristic angular shape. Night sweats are a well-documented symptom of TB infection, according to the NHS, though they are also associated with all sorts of other conditions.

The case is a reminder that TB can affect parts of the body well beyond the lungs. Back pain is one of the most common reasons people visit a GP, and the bulk of cases have straightforward muscular or mechanical causes. But persistent pain that doesn’t improve, combined with symptoms such as unexplained night sweats, unintentional weight loss, or fever, warrants a conversation with a doctor.

Anyone concerned about persistent back pain or symptoms that could suggest an underlying infection should contact their GP in the first instance. NHS 111 is available by phone or online for urgent queries outside of surgery hours.