Study Design. Case report.
Objective. To characterise the paleopathology presented in the
skeleton of a 45-50-year-old male indicative of tuberculous
spondylitis and to confirm by the detection of ancient DNA.
Summary of Background Data. Tuberculosis (TB) is an infectious
disease prevalent in both present and ancient human populations.
The disease is primarily located within the lungs, so although
characacteristic bone lesions can lead to a clear diagnosis,
skeletal TB occurs in only 5-6% of TB infections, even in
historical cases. In addition, the visual appearance of human
skeletal remains may be influenced by the environmental
conditions at the burial site. However, it is important to
recognise ancient skeletal TB, because this can provide
important data on the history of Mycobacterium tuberculosis and
gives an unique opportunity for physicians to observe the
natural outcome of the infection from the pre-antibiotic era.
Methods. Paleopathological analysis was carried out using
careful visual observation supported by ancient DNA analysis.
Approximately 60 mg of bone powder from rib fragments was
examined and DNA from the M. tuberculosis complex was detected
by PCR targeting specific genetic loci of the IS6110 and IS1081
Results. The skeleton is part of a human osteoarchaeological
collection (n = 274) from the 12th-13th century Transylvanian
archaeological site of Peteni, in modern-day Romania. The
individual, a 45-50-year-old male, showed gross pathology
typical of tuberculous spondylitis. The paleopathological
diagnosis was supported by analysis for M. tuberculosis complex
Conclusions. This case demonstrates that TB was present in
Transylvania (Romania) during the 12-13th century and adds to
the growing body of knowledge on the history of this disease.
(C) 2012 Lippincott Williams & Wilkins, Inc.