MKHIWA Private Hospital neurosurgeon Dr Rafael Cespedes has identified the first exceptional rare case of Conus Medullaris Tuberculoma in the country.
This is a form of spinal tuberculosis that affects the lower end of the spinal cord, making the local case the 15th one reported globally.
This discovery places Mkhiwa Private Hospital and Eswatini on the global medical map, as only 14 cases of this condition have been reported worldwide in English medical literature.
While tuberculosis is common in many parts of the world, tuberculomas of the spinal cord is rare, with approximately 170 cases reported globally.
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When the infection occurs specifically in the conus medullaris region, the lower part of the spinal cord responsible for leg movement and bladder control becomes extraordinarily rare, even in TB-endemic areas.
“This case is truly exceptional. The patient had visited several facilities before coming to Mkhiwa. It was through imaging and careful neurological assessment that we were able to identify the true cause of the symptoms. Early diagnosis and specialised care make all the difference,” he said.
Mkhiwa Private Hospital emphasised that such discoveries highlight the importance of specialised expertise and access to advanced diagnostic facilities locally.
The institution stated that the patient, who had been struggling with progressive weakness and difficulty walking, is now under the dedicated care of the Mkhiwa neuro team, and the hospital reported that the patient is responding positively to treatment.
“We are extremely proud of Dr. Cespedes and our team. This is not only a rare medical discovery, but also a moment of hope, showing that with the right care, even the most complex conditions can be diagnosed and treated here at home,” said Mkhiwa Private Hospital Patient Liaison Tony Owolaranfe.
He stated that the hospital remained optimistic about the patient’s recovery and continued to share this achievement with the broader medical community as part of Mkhiwa’s mission to advance healthcare and medical excellence in Eswatini.
According to the National Institutes of Health (NIH), patients diagnosed with Conus Medullaris Tuberculoma could survive, and the prognosis was generally good with appropriate and timely anti-tuberculosis therapy.
The NIH noted that in most cases, patients experience complete clinical and neurological recovery, however stating that the condition could become life-threatening if left untreated, if diagnosis and treatment are delayed, or if the infection proves resistant to medication.
Symptoms of Conus Medullaris Tuberculoma:
• Severe back and perinea pain
• Symmetric lower limb weakness and sensory deficits
• Early bowel/bladder dysfunction (retention or incontinence).
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