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Despite numerous descriptive publications, the guidelines for treatment of cervical spinal tuberculosis (TB) are not very clear. The authors report a case of a young girl with cervico-thoracic spinal TB extending from C5 to T3 vertebrae presenting with weakness of the right hand and unsteady gait. An 11-year-old female who is an immigrant to the UK from Afghanistan, presented to our clinic with a 10-day history of difficulty in walking with an unsteady gait and 3-month history of progressive weakness in both her arms, the right side more affected than the left. Her immunisation history was unclear. Examination of the arms showed bilateral thenar and hypothenar wasting, more so on the right than the left. An MRI scan revealed a large para-spinal abscess extending from C3/4 to T4/5 with a significant anterior epidural cord compression from C5/6 to T2/3. Therapeutic/diagnostic aspiration was performed under ultrasound guidance and the aspirate was sent for microbiology. She was started empirically on multidrug anti-tubercular treatment and steroids. Although Ziehl–Neelsen stain was negative for acid-fast bacilli, microbiological confirmation of TB was obtained by positive TB culture sensitive to all first-line anti-TB drugs. She made a dramatic improvement within 3 weeks of anti-tubercular treatment. A follow-up MRI scan at 8 months showed complete resolution of the abscess. At 2 years of follow-up, she was a healthy looking child, back to her school with no residual clinical signs/symptoms of the disease. Our case of cervico-thoracic tuberculous abscess in a young child suggests that even with incomplete neurological deficit caused by epidural cord compression, ultrasound (or CT)-guided aspiration and anti-tubercular medication provide acceptable results at 2 years of follow-up.

The conservation of foodstuffs by chemical or physical methods is now practiced on a wide scale. Certain procedures (drying, use of pesticides) are well proved and are used on an industrial scale, although in certain situations they are not without risk to human health. New techniques (controlled atmospheres, irradiation, fumigation) are in use and will undoubtedly see further development for conservation of seeds and cereals in both industrialized and non-industrialized countries. In the latter case, the use of cost-effective fumigants may be of particular value. Preventive measures for the control of molds in foodstuffs are discussed in this report.

Production of aflatoxins by Aspergillus ruber THOM and CHURCH was first reported by KULIK and HOLADAY (1967), although these results have lacked confirmation. In this paper we provide evidence that this fungal strain produces aflatoxins. This finding has implications for food hygiene, especially in countries where such moulds are used in the preparation of foodstuffs.