{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T19:32:22Z","timestamp":1778873542602,"version":"3.51.4"},"reference-count":97,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Szeged Open Access Fund","award":["5006"],"award-info":[{"award-number":["5006"]}]},{"name":"National Research, Development and Innovation Office","award":["K 125561"],"award-info":[{"award-number":["K 125561"]}]},{"name":"Hungarian Ministry of Human Capacities","award":["39509\/2018\/KFSZ"],"award-info":[{"award-number":["39509\/2018\/KFSZ"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Ancient human remains exhibiting bony changes consistent with osteoarticular tuberculosis (OATB) indicate that the disease has afflicted mankind for millennia. Nonetheless, not many pediatric OATB cases have been published in the paleopathological literature\u2013from Hungary, only three cases have been described up to now. In our paper, we demonstrate a child (<jats:bold>S0603<\/jats:bold>) from the \u00c1rp\u00e1dian Age cemetery of Gy\u0151rszentiv\u00e1n-R\u00e9vhegyi tag (northwestern Hungary), who represents a unique case of OATB regarding both the pattern and severity of the observed bony changes. During the macromorphological and radiological investigations, the most serious alterations were discovered in the upper thoracic spine\u2013the development of osteolytic lesions led to severe bone loss and consequent collapse and fusion of several adjacent vertebrae. The pathological process terminated in a sharp, rigid angular kyphosis. Disruption of the normal spine curvature resulted in consequent deformation of the whole thoracic wall\u2013it became \u201crugby-ball-shaped\u201d. The overall nature and pattern of the detected alterations, as well as their resemblance to those of described in previously published archaeological and modern cases from the pre-antibiotic era indicate that they are most consistent with OATB. Based on the severity and extent of the lesions, as well as on the evidence of secondary healing, <jats:bold>S0603<\/jats:bold> suffered from TB for a long time prior to death. Besides body deformation, OATB resulted in consequent disability in daily activities, which would have required regular and significant care from others to survive. It implies that in the \u00c1rp\u00e1dian Age community of Gy\u0151rszentiv\u00e1n-R\u00e9vhegyi tag, there was a willingness to care for people in need. Detailed archaeological case studies can give us a unique insight into the natural history and different presentations of OATB. Furthermore, they can provide paleopathologists with a stronger basis for diagnosing TB and consequently, with a more sensitive means of assessing TB frequency in past populations.<\/jats:p>","DOI":"10.1371\/journal.pone.0249939","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T22:23:59Z","timestamp":1618439039000},"page":"e0249939","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["An unusual case of childhood osteoarticular tuberculosis from the \u00c1rp\u00e1dian Age cemetery of Gy\u0151rszentiv\u00e1n-R\u00e9vhegyi tag (Gy\u0151r-Moson-Sopron county, Hungary)"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0350-1906","authenticated-orcid":true,"given":"Olga","family":"Spekker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Kis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"De\u00e1k","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eszter","family":"Makai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gy\u00f6rgy","family":"P\u00e1lfi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orsolya Anna","family":"V\u00e1radi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Moln\u00e1r","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"pone.0249939.ref001","doi-asserted-by":"crossref","first-page":"a865436","DOI":"10.1155\/2012\/865436","article-title":"Childhood TB surveillance: Bridging the knowledge gap to inform policy","volume":"2012","author":"AJ Brent","year":"2012","journal-title":"J Trop Med"},{"issue":"5","key":"pone.0249939.ref002","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.pedneo.2013.01.019","article-title":"Childhood tuberculosis: Epidemiology, diagnosis, treatment, and vaccination","volume":"54","author":"K-S Tsai","year":"2013","journal-title":"Pediatr Neonatol"},{"issue":"133","key":"pone.0249939.ref003","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1183\/09059180.00005314","article-title":"Childhood tuberculosis: A concern of the modern world","volume":"23","author":"A Hamzaoui","year":"2014","journal-title":"Eur Respir Rev"},{"issue":"3","key":"pone.0249939.ref004","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S1473-3099(16)30474-1","article-title":"Mortality in children diagnosed with tuberculosis: A systematic review and meta-analysis","volume":"17","author":"HE Jenkins","year":"2017","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"pone.0249939.ref005","doi-asserted-by":"crossref","first-page":"e845","DOI":"10.1016\/S2214-109X(17)30305-4","article-title":"Tuberculosis in children: Under-counted and under-treated","volume":"5","author":"EA Kendall","year":"2017","journal-title":"Lancet Glob Health"},{"issue":"2","key":"pone.0249939.ref006","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1590\/s1806-37562017000000461","article-title":"Epidemiological aspects, clinical manifestations, and prevention of pediatric tuberculosis from the perspective of the End TB Strategy","volume":"44","author":"ACC Carvalho","year":"2018","journal-title":"J Bras Pneumol"},{"key":"pone.0249939.ref007","first-page":"27","volume-title":"In: Global tuberculosis report 2019","author":"World Health Organization","year":"2019"},{"issue":"931","key":"pone.0249939.ref008","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1136\/pmj.79.931.272","article-title":"Paediatric tuberculosis","volume":"79","author":"W. 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