[A case of pulmonary tuberculosis complicated with spinal caries improved by the nutrition management of percutaneous endoscopic gastrostomy].

The case was 71-year-old woman. She was diagnosed as drug sensitive pulmonary tuberculosis (bII3 by the GAKKAI classification) and the chemotherapy with INH, RFP, EB and PZA was started. Two months later back pain and hemiparesis of both lower limbs appeared and it was diagnosed as caries of the 10th thoracic vertebrae. Because she was confined to bed and impossible to eat orally, the parenteral-hyperalimentaiton therapy was started with the central vein catheter. Howerer, nutritional state, pulmonary tuberculosis lesions and caries symptoms deteriorated. Then percutaneous endoscopic gastrostomy was performed and enteral nutrition was started. Since then nutritional state and tuberculosis lesions including caries improved gradually. It was estimated that the enteral nutrition brought about recovery of function and immunity of her digestive tract. For patients with advanced tuberculosis with poor nutritional state, the enteral nutrition is a useful adjuvant therapy, and the gastrostoma is considered to be one of the effective administrational routes when oral ingestion is difficult.