{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T23:57:36Z","timestamp":1793404656474,"version":"4.5.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Cape Town"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Tuberculosis (TB) is caused by <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (<jats:italic>Mtb<\/jats:italic>) and typically infects the lungs. However, extrapulmonary forms of TB can be found in approximately 20% of cases. It is suggested, that up to 10% of extrapulmonary TB affects the musculoskeletal system, in which spinal elements (spinal tuberculosis, STB) are involved in approximately 50% of the cases. STB is a debilitating disease with nonspecific symptoms and diagnosis is often delayed for months to years. In our Spinal TB X Cohort, we aim to describe the clinical phenotype of STB using whole-body 18\u00a0F-fluorodeoxyglucose positron emission tomography computed tomography (PET\/CT) and to identify a specific gene expression profile for the different stages of dissemination on PET\/CT. Here we report on the first patient recruited into our cohort who underwent PET\/CT before treatment initiation, at 6-months and at 12-months - time of TB treatment completion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 27-year-old immunocompetent male presented with severe thoracolumbar back pain for 9 months with severe antalgic gait and night sweats. Magnetic resonance imaging (MRI) of the whole spine revealed multilevel spinal disease (T5\/6, T11\/12, L3\/4) in keeping with STB. After informed consent and recruitment into the Spinal TB X Cohort, the patient underwent PET\/CT as per protocol, which revealed isolated multilevel STB (T4-7, T11\/12, L3\/4) with no concomitant lung or urogenital lesion. However, sputum and urine were Xpert MTB\/RIF Ultra positive and <jats:italic>Mtb<\/jats:italic> was cultured from the urine sample. CT-guided biopsy of the T11\/12 lesion confirmed drug-sensitive <jats:italic>Mtb<\/jats:italic> on Xpert MTB\/RIF Ultra and the patient was started on TB treatment according to local guidelines for 12 months. The 6-month follow-up PET\/CT revealed new and existing spinal lesions with increased FDG-uptake despite significant improvement of clinical features and laboratory markers. After 9 months of treatment, the patient developed an acute urethral stricture, most likely due to urogenital TB, and a suprapubic catheter was inserted. The 12-month PET\/CT showed significantly decreased PET\/CT values of all lesions, however, significant persistent spinal inflammation was present at the end of TB treatment. Clinically, the patient was considered cured by the TB control program and currently awaits urethroplasty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In our case, PET\/CT emerged as a valuable imaging modality for the initial assessment, surpassing MRI by revealing more comprehensive extensive disease. Subsequent PET\/CT scans at 6-month uncovered new lesions and increased inflammation in existing ones, while by the end of TB treatment, all lesions exhibited improvement. However, the interpretation of FDG avidity remains ambiguous, whether it correlates with active infection and viable Mtb. or fibro- and osteoblast activity indicative of the healing process. Additionally, the absence of extraspinal TB lesions on PET\/CT despite positive microbiology from sputum and urine maybe explained by paucibacillary, subclinical infection of extraspinal organs. The Spinal TB X Cohort endeavours to shed light on whole-body imaging patterns at diagnosis, their evolution midway through TB treatment, and upon treatment completion. Ultimately, this study aims to advance our understanding of the biology of this complex disease.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s15010-024-02327-5","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T08:01:54Z","timestamp":1718784114000},"page":"2507-2519","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multi-level tuberculosis of the spine identified by 18\u00a0F-FDG-PET\/CT and concomitant urogenital tuberculosis: a case report from the spinal TB X cohort"],"prefix":"10.1007","volume":"52","author":[{"given":"Julian","family":"Scherer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra L.","family":"Mukasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Wolmarans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Guler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Kotze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeksun","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maritz","family":"Laubscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Christoph","family":"Pape","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Held","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich","family":"Thienemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"2327_CR1","volume-title":"Global tuberculosis report 2022","author":"O World Health","year":"2022","unstructured":"World Health O. Global tuberculosis report 2022. Geneva: World Health Organization; 2022."},{"key":"2327_CR2","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1056\/NEJMra1200894","volume":"368","author":"A Zumla","year":"2013","unstructured":"Zumla A, Raviglione M, Hafner R. Fordham Von Reyn C. Tuberculosis. N Engl J Med. 2013;368:745\u201355.","journal-title":"N Engl J Med"},{"key":"2327_CR3","volume-title":"Tuberculosis surveillance and monitoring in Europe 2022\u20132020 data","author":"European Centre for Disease Prevention and Control, WHO Regional Office for Europe","year":"2022","unstructured":"European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2022\u20132020 data. Copenhagen: WHO Regional Office for Europe and Stockholm: European Centre for Disease Prevention and Control;; 2022. Licence: CC BY 3.0 IGO."},{"key":"2327_CR4","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1302\/0301-620X.100B4.BJJ-2017-1040.R1","volume":"100\u2013B","author":"RN Dunn","year":"2018","unstructured":"Dunn RN, Husien MB. Spinal tuberculosis. Bone Joint J. 2018;100\u2013B:425\u201331.","journal-title":"Bone Joint J"},{"key":"2327_CR5","doi-asserted-by":"publisher","first-page":"s96","DOI":"10.1177\/2192568218769053","volume":"8","author":"S Rajasekaran","year":"2018","unstructured":"Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal tuberculosis: current concepts. Global Spine J. 2018;8:s96\u2013108.","journal-title":"Global Spine J"},{"key":"2327_CR6","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/978-981-16-9495-0_3","volume-title":"Tuberculosis of the spine","author":"D Neradi","year":"2022","unstructured":"Neradi D, Sengupta DK. Epidemiology of tuberculosis of spine. In: Dhatt SS, Kumar V, editors. Tuberculosis of the spine. Singapore: Springer Nature Singapore; 2022. pp. 21\u20139."},{"key":"2327_CR7","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1016\/j.cmi.2015.07.013","volume":"21","author":"A Batirel","year":"2015","unstructured":"Batirel A, Erdem H, Sengoz G, Pehlivanoglu F, Ramosaco E, G\u00fcls\u00fcn S, et al. The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study. Clin Microbiol Infect. 2015;21:1008. .e9-.e18.","journal-title":"Clin Microbiol Infect"},{"key":"2327_CR8","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1097\/BRS.0b013e3181d265c0","volume":"36","author":"R Dunn","year":"2011","unstructured":"Dunn R, Zondagh I, Candy S. Spinal tuberculosis: magnetic resonance imaging and neurological impairment. Spine (Phila Pa 1976). 2011;36:469\u201373.","journal-title":"Spine (Phila Pa 1976)"},{"key":"2327_CR9","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1001\/jama.1986.03380030064029","volume":"256","author":"G Sunderam","year":"1986","unstructured":"Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, Reichman LB. Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA. 1986;256:362\u20136.","journal-title":"JAMA"},{"key":"2327_CR10","first-page":"316","volume":"120","author":"SK Sharma","year":"2004","unstructured":"Sharma SK, Mohan A. Extrapulmonary Tuberculosis. Indian J Med Res. 2004;120:316\u201353.","journal-title":"Indian J Med Res"},{"key":"2327_CR11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.4081\/monaldi.2004.714","volume":"61","author":"A Kaya","year":"2004","unstructured":"Kaya A, Topu Z, Fitoz S, Numanoglu N. Pulmonary tuberculosis with multifocal skeletal involvement. Monaldi Arch Chest Dis. 2004;61:133\u20135.","journal-title":"Monaldi Arch Chest Dis"},{"key":"2327_CR12","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1179\/2045772311Y.0000000023","volume":"34","author":"RK Garg","year":"2011","unstructured":"Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med. 2011;34:440\u201354.","journal-title":"J Spinal Cord Med"},{"key":"2327_CR13","doi-asserted-by":"crossref","unstructured":"Waters R, Laubscher M, Dunn RN, Adikary N, Coussens AK, Held M. Higher sensitivity of Xpert MTB\/RIF Ultra over Tuberculosis Culture for the diagnosis of spinal tuberculosis with Open or computed tomography\u2013guided biopsies. Open Forum Infect Dis. 2023;11.","DOI":"10.1093\/ofid\/ofad621"},{"key":"2327_CR14","doi-asserted-by":"publisher","first-page":"45","DOI":"10.12659\/PJR.883628","volume":"77","author":"A Ma\u0142kiewicz","year":"2012","unstructured":"Ma\u0142kiewicz A, Dziedzic M. Bone marrow reconversion - imaging of physiological changes in bone marrow. Pol J Radiol. 2012;77:45\u201350.","journal-title":"Pol J Radiol"},{"key":"2327_CR15","first-page":"1356","volume":"55","author":"N Plaxton","year":"2014","unstructured":"Plaxton N, Moncayo V, Barron B, Halkar R. Factors that influence standard uptake values in FDG PET\/CT. J Nucl Med. 2014;55:1356.","journal-title":"J Nucl Med"},{"key":"2327_CR16","doi-asserted-by":"publisher","first-page":"9","DOI":"10.12688\/gatesopenres.12750.1","volume":"1","author":"RY Chen","year":"2017","unstructured":"Chen RY, Via LE, Dodd LE, Walzl G, Malherbe ST, Loxton AG, et al. Using biomarkers to predict TB treatment duration (predict TB): a prospective, randomized, noninferiority, treatment shortening clinical trial. Gates Open Res. 2017;1:9.","journal-title":"Gates Open Res"},{"key":"2327_CR17","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1136\/thx.2003.019224","volume":"59","author":"RAM Breen","year":"2004","unstructured":"Breen RAM, Smith CJ, Bettinson H, Dart S, Bannister B, Johnson MA, et al. Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax. 2004;59:704\u20137.","journal-title":"Thorax"},{"key":"2327_CR18","first-page":"527","volume":"72","author":"C Choremis","year":"1955","unstructured":"Choremis C, Padiatellis C, Zoumboulakis D, Yannakos D. Transitory exacerbation of fever and roentgenographic findings during treatment of tuberculosis in children. Am Rev Tuberculosis Pulmonary Dis. 1955;72:527\u201336.","journal-title":"Am Rev Tuberculosis Pulmonary Dis"},{"key":"2327_CR19","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1183\/09059180.00003709","volume":"18","author":"S Bloch","year":"2009","unstructured":"Bloch S, Wickremasinghe M, Wright A, Rice A, Thompson M, Kon OM. Paradoxical reactions in non-HIV tuberculosis presenting as endobronchial obstruction. Eur Respiratory Rev. 2009;18:295\u20139.","journal-title":"Eur Respiratory Rev"},{"key":"2327_CR20","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1038\/sc.2015.58","volume":"53","author":"RK Garg","year":"2015","unstructured":"Garg RK, Malhotra HS, Gupta R. Spinal cord involvement in tuberculous meningitis. Spinal Cord. 2015;53:649\u201357.","journal-title":"Spinal Cord"},{"key":"2327_CR21","doi-asserted-by":"publisher","first-page":"bcr2014203639","DOI":"10.1136\/bcr-2014-203639","volume":"2014","author":"R Sahu","year":"2014","unstructured":"Sahu R, Chaudhari TS, Junewar V, Shukla R. Spinal cord tuberculosis: a paradoxical response to antituberculous therapy. BMJ Case Rep. 2014;2014:bcr2014203639.","journal-title":"BMJ Case Rep"},{"key":"2327_CR22","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1056\/NEJMoa1800762","volume":"379","author":"G Meintjes","year":"2018","unstructured":"Meintjes G, Stek C, Blumenthal L, Thienemann F, Schutz C, Buyze J, et al. Prednisone for the Prevention of Paradoxical Tuberculosis-Associated IRIS. N Engl J Med. 2018;379:1915\u201325.","journal-title":"N Engl J Med"},{"key":"2327_CR23","doi-asserted-by":"publisher","first-page":"2871","DOI":"10.1097\/QAD.0b013e328340fe76","volume":"24","author":"V Asselman","year":"2010","unstructured":"Asselman V, Thienemann F, Pepper DJ, Boulle A, Wilkinson RJ, Meintjes G, et al. Central nervous system disorders after starting antiretroviral therapy in South Africa. Aids. 2010;24:2871\u20136.","journal-title":"Aids"},{"key":"2327_CR24","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.ijid.2014.12.030","volume":"32","author":"LC Bell","year":"2015","unstructured":"Bell LC, Breen R, Miller RF, Noursadeghi M, Lipman M. Paradoxical reactions and immune reconstitution inflammatory syndrome in tuberculosis. Int J Infect Dis. 2015;32:39\u201345.","journal-title":"Int J Infect Dis"},{"key":"2327_CR25","doi-asserted-by":"publisher","first-page":"e20012","DOI":"10.1097\/MD.0000000000020012","volume":"99","author":"CE Volpe-Chaves","year":"2020","unstructured":"Volpe-Chaves CE, Lacerda M, Castilho SB, Fonseca SSO, Saad BAA, Franciscato C, et al. Vertebral tuberculosis as a paradoxical reaction to the treatment of pulmonary and meningeal tuberculosis in an immunocompetent patient: a case report. Med (Baltim). 2020;99:e20012.","journal-title":"Med (Baltim)"},{"key":"2327_CR26","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1093\/cid\/civ995","volume":"62","author":"YL Xie","year":"2015","unstructured":"Xie YL, Rosen LB, Sereti I, Barber DL, Chen RY, Hsu DC, et al. Severe paradoxical reaction during treatment of disseminated tuberculosis in a patient with neutralizing Anti-IFN\u03b3 autoantibodies. Clin Infect Dis. 2015;62:770\u20133.","journal-title":"Clin Infect Dis"},{"key":"2327_CR27","doi-asserted-by":"publisher","first-page":"271","DOI":"10.3109\/00365548.2014.990508","volume":"47","author":"JH Im","year":"2015","unstructured":"Im JH, Baek JH, Kwon HY, Lee JS. Paradoxical reaction of tuberculous vertebral osteomyelitis: a case series. Infect Dis. 2015;47:271\u20134.","journal-title":"Infect Dis"},{"key":"2327_CR28","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1053\/j.semnuclmed.2017.07.005","volume":"47","author":"G Garg","year":"2017","unstructured":"Garg G, Benchekroun MT, Abraham T. FDG-PET\/CT in the postoperative period: utility, expected findings, complications, and Pitfalls. Semin Nucl Med. 2017;47:579\u201394.","journal-title":"Semin Nucl Med"},{"key":"2327_CR29","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1258\/0007142991902673","volume":"55","author":"DR Marsh","year":"1999","unstructured":"Marsh DR, Li G. The biology of fracture healing: optimising outcome. Br Med Bull. 1999;55:856\u201369.","journal-title":"Br Med Bull"},{"key":"2327_CR30","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1038\/nm.4177","volume":"22","author":"ST Malherbe","year":"2016","unstructured":"Malherbe ST, Shenai S, Ronacher K, Loxton AG, Dolganov G, Kriel M, et al. Persisting positron emission tomography lesion activity and Mycobacterium tuberculosis mRNA after tuberculosis cure. Nat Med. 2016;22:1094\u2013100.","journal-title":"Nat Med"},{"key":"2327_CR31","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.3390\/jcm9051581","volume":"9","author":"C Altini","year":"2020","unstructured":"Altini C, Lavelli V, Niccoli-Asabella A, Sardaro A, Branca A, Santo G, et al. Comparison of the diagnostic value of MRI and whole body 18F-FDG PET\/CT in diagnosis of Spondylodiscitis. J Clin Med. 2020;9:1581.","journal-title":"J Clin Med"},{"key":"2327_CR32","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.tube.2016.02.010","volume":"98","author":"CR Diedrich","year":"2016","unstructured":"Diedrich CR, O\u2019Hern J, Wilkinson RJ. HIV-1 and the Mycobacterium tuberculosis granuloma: a systematic review and meta-analysis. Tuberculosis. 2016;98:62\u201376.","journal-title":"Tuberculosis"},{"key":"2327_CR33","first-page":"e18","volume":"6","author":"H Abdul","year":"2010","unstructured":"Abdul H, Abdul N, Nordin A. Dual time point imaging of FDG PET\/CT in a tuberculous spondylodiscitis. Biomed Imaging Interv J. 2010;6:e18\u2013e.","journal-title":"Biomed Imaging Interv J"},{"key":"2327_CR34","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1007\/s00256-017-2615-8","volume":"46","author":"M Bassetti","year":"2017","unstructured":"Bassetti M, Merelli M, Di Gregorio F, Della Siega P, Screm M, Scarparo C, et al. Higher fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in tuberculous compared to bacterial spondylodiscitis. Skeletal Radiol. 2017;46:777\u201383.","journal-title":"Skeletal Radiol"},{"key":"2327_CR35","first-page":"23","volume":"19","author":"D Jh","year":"2020","unstructured":"Jh D, Mc B, Pienaar G, Rp L. 18F-FDG PET\/CT as a modality for the evaluation of persisting raised infective markers in patients with spinal tuberculosis. SA Orthop J. 2020;19:23\u20137.","journal-title":"SA Orthop J"},{"key":"2327_CR36","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1007\/s00259-014-2898-0","volume":"42","author":"D Fuster","year":"2015","unstructured":"Fuster D, Tomas X, Mayoral M, Soriano A, Manchon F, Cardenal C, et al. Prospective comparison of whole-body F-18-FDG PET\/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis. Eur J Nucl Med Mol Imaging. 2015;42:264\u201371.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"2327_CR37","doi-asserted-by":"publisher","first-page":"2961","DOI":"10.2169\/internalmedicine.51.8347","volume":"51","author":"SW Go","year":"2012","unstructured":"Go SW, Lee HY, Lim CH, Jee W-H, Wang Y-P, Yoo IR, et al. Atypical disseminated skeletal tuberculosis mimicking metastasis on PET-CT and MRI. Intern Med. 2012;51:2961\u20135.","journal-title":"Intern Med"},{"key":"2327_CR38","doi-asserted-by":"crossref","unstructured":"Rai A, Dahuja A, Choudhary R, Sharma A, Sankhla S. Sequential imaging characteristics and potential role of F18 Fluorodeoxyglucose Positron Emission Tomography\/CT in the Evaluation of Treatment Response in cases of spinal tuberculosis without neurological involvement: results from a pilot study. Cureus J Med Sci. 2022;14.","DOI":"10.7759\/cureus.26065"},{"key":"2327_CR39","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1055\/s-0042-1746176","volume":"21","author":"S Sampath","year":"2022","unstructured":"Sampath S, Basumani P, Kothandaraman A, Ramakrishnan R. Detection of spinal tuberculosis by F-18 FDG PET\/CT as a cause of unusual Referred Pain in the right Upper Quadrant of Abdomen. World J Nuclear Med. 2022;21:69\u201372.","journal-title":"World J Nuclear Med"},{"key":"2327_CR40","doi-asserted-by":"crossref","unstructured":"Wang C, Luan Y, Liu S, Zhao M, Zhang H, Li W et al. Multifocal tuberculosis simulating a cancer-a case report. BMC Infect Dis. 2020;20.","DOI":"10.1186\/s12879-020-05209-x"},{"key":"2327_CR41","doi-asserted-by":"publisher","first-page":"310","DOI":"10.2214\/AJR.10.4923","volume":"195","author":"MC Adams","year":"2010","unstructured":"Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. Am J Roentgenol. 2010;195:310\u201320.","journal-title":"Am J Roentgenol"},{"key":"2327_CR42","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1007\/s00330-005-2767-0","volume":"16","author":"P Veit","year":"2006","unstructured":"Veit P, Antoch G, Stergar H, Bockisch A, Forsting M, Kuehl H. Detection of residual tumor after radiofrequency ablation of liver metastasis with dual-modality PET\/CT: initial results. Eur Radiol. 2006;16:80\u20137.","journal-title":"Eur Radiol"},{"key":"2327_CR43","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s40336-017-0259-2","volume":"6","author":"H Sj\u00f6lander","year":"2018","unstructured":"Sj\u00f6lander H, Str\u00f8msnes T, Gerke O, Hess S. Value of FDG-PET\/CT for treatment response in tuberculosis: a systematic review and meta-analysis. Clin Translational Imaging. 2018;6:19\u201329.","journal-title":"Clin Translational Imaging"},{"key":"2327_CR44","doi-asserted-by":"publisher","first-page":"S629","DOI":"10.1093\/infdis\/jix362","volume":"216","author":"G Churchyard","year":"2017","unstructured":"Churchyard G, Kim P, Shah NS, Rustomjee R, Gandhi N, Mathema B, et al. What we know about Tuberculosis Transmission: an overview. J Infect Dis. 2017;216:S629\u201335.","journal-title":"J Infect Dis"},{"key":"2327_CR45","unstructured":"Delgado BJ, Bajaj T. Ghon Complex. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Tushar Bajaj declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright \u00a9 2024. StatPearls Publishing LLC.; 2024."},{"key":"2327_CR46","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.ijid.2014.12.007","volume":"32","author":"E Skoura","year":"2015","unstructured":"Skoura E, Zumla A, Bomanji J. Imaging in tuberculosis. Int J Infect Dis. 2015;32:87\u201393.","journal-title":"Int J Infect Dis"},{"key":"2327_CR47","doi-asserted-by":"crossref","unstructured":"Cardona P-J. Understanding the bacillary load and host interaction to design a point-of-care test to diagnose tuberculosis. Front Tuberculosis. 2023;1.","DOI":"10.3389\/ftubr.2023.1243479"},{"key":"2327_CR48","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.jinf.2010.04.002","volume":"61","author":"H Karcher","year":"2010","unstructured":"Karcher H, Epple HJ, Schneider T, Eckmanns T, John P, Schweickert B. Nosocomial transmission of tuberculous otitis media in an ear, nose and throat outpatient unit: a clinical and hygienical investigation. J Infect. 2010;61:96\u20139.","journal-title":"J Infect"},{"key":"2327_CR49","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1038\/sj.sc.3102150","volume":"46","author":"L Godlwana","year":"2008","unstructured":"Godlwana L, Gounden P, Ngubo P, Nsibande T, Nyawo K, Puckree T. Incidence and profile of spinal tuberculosis in patients at the only public hospital admitting such patients in KwaZulu-Natal. Spinal Cord. 2008;46:372\u20134.","journal-title":"Spinal Cord"},{"key":"2327_CR50","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.jiph.2010.09.005","volume":"3","author":"SM Alavi","year":"2010","unstructured":"Alavi SM, Sharifi M. Tuberculous spondylitis: risk factors and clinical\/paraclinical aspects in the south west of Iran. J Infect Public Health. 2010;3:196\u2013200.","journal-title":"J Infect Public Health"},{"key":"2327_CR51","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1097\/00005792-198305000-00005","volume":"62","author":"GJ Gorse","year":"1983","unstructured":"Gorse GJ, Pais MJ, Kusske JA, Cesario TC. Tuberculous spondylitis. A report of six cases and a review of the literature. Med (Baltim). 1983;62:178\u201393.","journal-title":"Med (Baltim)"},{"key":"2327_CR52","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/01.rhu.0000152144.91206.0c","volume":"11","author":"N Schlesinger","year":"2005","unstructured":"Schlesinger N, Lardizabal A, Rao J, Rao J, McDonald R. Tuberculosis of the spine: experience in an inner city hospital. J Clin Rheumatol. 2005;11:17\u201320.","journal-title":"J Clin Rheumatol"},{"key":"2327_CR53","doi-asserted-by":"publisher","first-page":"e659","DOI":"10.1016\/j.ijid.2009.11.009","volume":"14","author":"P Schirmer","year":"2010","unstructured":"Schirmer P, Renault CA, Holodniy M. Is spinal tuberculosis contagious? Int J Infect Dis. 2010;14:e659\u201366.","journal-title":"Int J Infect Dis"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-024-02327-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-024-02327-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-024-02327-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T20:02:34Z","timestamp":1733428954000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-024-02327-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":53,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["2327"],"URL":"https:\/\/doi.org\/10.1007\/s15010-024-02327-5","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]},"assertion":[{"value":"30 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The University of Cape Town Ethics Committee approved the Spinal TB X cohort (HREC:243\/2022). The study has been registered on ClinicalTrials.gov (NCT05610098).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants from the Spinal TB X cohort undergo written informed consent before inclusion.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The participant in this study has signed the written consent for publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}