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PubMed2003

[Pott's disease and different clinical presentations Pott's disease and different clinical presentations].

Skeletal tuberculosis remains a potentially crippling disease in the developing world; particularly as it usually affects children and young adults. The spine is involved approximately 50% of bone and joint tuberculosis cases. The features of four spinal tuberculosis cases were looked over this article. Their ages were between 18 and 76 years. All of them were male and immunocompetent. Pain was the major complaint. There was no life-threatening neurological sign. Among them, a case who was admitted to the hospital with painful torticollis had upper cervical-lower thoracic spinal tuberculosis with psoas abscesses and peritoneal tuberculosis, but no pulmonary involvement. The other cases had thoracolumbal spinal tuberculosis with psoas abscesses and pulmonary tuberculosis of which miliary, chronic and new pulmonary tuberculosis. The whole diagnosis of spinal tuberculosis was made by radiographically-MRI and CT-. Specific antituberculous therapy with supportive care was begun and remarkable responses without surgical intervention were seen on them except miliary pulmonary tuberculosis case. The aim of this presentation was to emphasize the importance of early diagnosis so that adequate pharmacological treatment can be initiated to avoid serious complication.

Adolescent↗
PubMedDate not supplied

[Pott's disease before antibercular agents: from Pott to Ménard].

Percival Pott (1714-1788), an eminent surgeon, has given his name to a spinal pathology with curvature due to tuberculous abscesses; he was the first to show that it may cause paralysis of the lower limbs and that tragic consequences could be avoided or reversed through surgery. Victor Auguste Ménard (1854-1934) played a major role in the orthopaedic treatment of this disease in the Maritime Hospital of Berck-sur-Mer where he was the founder of a surgeon school. In 1900, he published a work entitled : A Practical Study of Pott's Disease. Since there were no antibiotics to treat tuberculosis and because most patients were children, they had to be submitted to intensive care. Ménard's treatment consisted of a complete and long immobilization associated to strict rules of hygiene, involving sun and sea-air therapy. The use of surgery in some cases recalls Pott's general principles.

France↗
PubMedDate not supplied

[Diagnostic problems apropos of 2 clinical cases of lumbar Pott's disease].

Two cases of POTT's disease without radiological osteoarticular destructions have been diagnosed from a psoas and a dorsal abscess. Bacteriology and histology were negative at the beginning, then became positive after a long evolution of the wound. The recommendation is to think of POTT's disease when confronted with any paravertebral abscess, with or without radiological signs and to repeat the bacteriological and histological tests if necessary.

Adult↗
PubMed1992

[Unusual sites of Pott's disease. Apropos of fourteen cases].

The diagnosis of Pott's disease is generally easy exception unusual sites whose diagnosis is requires cross-section imaging and needle biopsy. The authors report 14 cases of atypical forms of Pott's disease: 7 cases of centro-somatic forms 4 cases of sub-occipital Pott's disease, 2 cases of posterior arch and one case of sub-ligamentous vertebral tuberculosis. The radiological diagnosis of Pott's disease is suggested by the presence of a paravertebral abscess noted in 12 cases tuberculous spondylitis associated in 3 cases and multifocal involvement in 9 cases.

Adult↗
PubMed2002

[Tuberculous spondylodiskitis (Pott's disease): Experience in a general hospital].

BACKGROUND: Pott's disease (PD) is an uncommon extra-pulmonary form of tuberculosis. Dissimilar data about location, diagnosis and treatment from various hospitals and different countries are reported. PATIENTS AND METHOD: We present our experience with Pott's disease at our institution between January 1993 to December 1999, retrospectively, based on clinical bacteriological and pathological research. We found the medical records of 14 patients diagnosed as having PD at our hospital. The following information was obtained: age, sex, symptoms and sings at presentation, PPD tuberculin skin test, imaging techniques, mycobacterium cultures and smear, histopathologic study, treatment and clinical outcome. RESULTS: The number of microbiological diagnosed tuberculosis during the study period was of 1,400 (4 cases per 1,000 admissions). From them, 1,047 cases (74.8%) were pulmonary and 353 cases (25.2%) extra-pulmonary. We found the medical records of 14 patients diagnosed as having PD at our hospital. There was a diagnostic delay between 2 and 720 days. In 5 cases, cultures were positive (1.4% extra-pulmonary). The following information was obtained: age, sex, symptoms and signs at presentation, PPD tuberculin skin test, imaging techniques, mycobacterium cultures and smear, histopathologic study, treatment and clinical outcome. The mean age of the patients was 58 years. Pain and dorsal location were more frequent (8/14). In 6 cases, tuberculosis was diagnosed at other sites. Tuberculin skin test was positive in 7 ases (50%). The diagnosis was confirmed by positive cultures from biopsies in 5 from 8 cases performed and the histology was compatible in 8 from 11 cases performed. Diskitis was presented in 10 cases, soft tissue abscess in 9 cases (psoas abscess in 2); epidural compression in 9 cases and surgery was necessary in 9 cases (diagnostic in 3). CONCLUSIONS: Pott's disease is a rare entity even among HIV-patients in whom extrapulmonar disease has increased. Dorsal location, diskitis and advanced forms of the disease that deserve surgical treatment are frequent.

Aged↗
PubMed2000

[Sub-occipital Pott's disease. Diagnostic imaging in 2 cases].

Pott's disease is the most common form of bone and joint tuberculosis, notably in the thoracolumbar spine. The sub-occipital localization remains exceptional, raising a major risk of spinal instability and severe bulbo-medullary complications. We report 2 new cases of tuberculous spondylodiscitis at the cervico-occipital junction revealed by signs of spinal compression associated with torticolis and dysphagia. The diagnosis was provided by CT scan and MR imaging and was confirmed histologically on a transoral biopsy of the retropharyngeal abscess. The patients were successfully treated with antituberculosis drugs combined with external stabilization of the spine. The diagnostic aspects, notably the neuroradiological findings in this particular localization of Pott's disease are recalled.

Adolescent↗
PubMed2006

Severe airway obstruction in a child with Pott's disease.

Airway obstruction associated with Pott's disease is rare. We present a case of severe airway obstruction caused by an extensive paravertebral mediastinal abscess in a 3-year-old boy with tuberculosis of the thoracic spine.

Airway Obstruction↗
PubMed1991

Atypical case of Pott's disease.

An unusual case of Pott's Disease in an adult, Australian born, caucasian male is reported. The typical and atypical radiological features of spinal tuberculosis are reviewed.

Aged↗
PubMed2003

Rupture of tuberculous spinal abscess resulting in tuberculous empyema and chylothorax.

STUDY DESIGN: Case report with a review of scientific literature. OBJECTIVE: To describe the course of tuberculous spinal disease (Pott's disease) complicated by pyogenic and tuberculous empyema, and chylothorax as there has been an increase in the numbers of notified cases of tuberculosis in the UK(1). To the best of our knowledge, a similar case has not been reported previously in the UK, although there has been a report of bilateral chylothorax associated with Pott's disease. SETTING: A national spinal injuries unit in a Scottish university teaching hospital. METHODS: Review of literature on the chemotherapy of spinal tuberculosis and the role of streptokinase in the treatment of empyema and the relation between spinal tuberculosis, empyema and chylothorax. RESULTS: Although spinal tuberculosis was recognised and treated appropriately with chemotherapy, the patient sustained pleural involvement with later development of both empyema and chylothorax. CONCLUSION: The case highlights the difficulties in the treatment of tuberculosis of the spine inspite of the presence of fully sensitive organisms and early institution of appropriate chemotherapy. In the absence of surgical debridement, the duration and dosage of chemotherapy as practised in the initial period may have to be prolonged into the continuation phase. The thoracic duct can be damaged either because of extension of the tuberculosis itself or because of instillation of intrapleural streptokinase for treatment of pleural empyema leading to chylothorax. There is a need for randomised trials of intrapleural streptokinase treatment in tuberculous empyema.

Aged↗
PubMed1986

Manifestations of Pott's disease in the head and neck.

Tuberculosis (TB) of the spine, or Pott's disease, is a rarely encountered clinical disorder in the United States today. However, Pott's disease should be strongly suspected in a person who presents with a destructive lesion of the spine involving adjacent vertebrae or a retropharyngeal mass which extends across the midline. The most common presenting signs and symptoms are pain and spinal deformity. The PPD skin test is usually positive, but unlike TB of the larynx, the chest roentgenogram is almost always negative. Diagnosis may be confirmed by needle aspiration or incisional biopsy and culture. The otolaryngologic literature has not previously addressed this clinical entity, thus, our experience with a patient with a retropharyngeal mass and quadriplegia diagnosed as Pott's disease will be presented. Subsequent medical therapy, stabilization, and odontoidectomy resulted in resolution of his neurological deficit. The incidence, pathogenesis, clinical features, and management of Pott's disease will be discussed.

Adult↗
PubMed2004

[Sub occipital Pott's disease: report of 8 cases].

Craniocervical Pott's disease remains exceptional, and may cause spinal instability and severe cervicomedullary complications. We report eight cases of tuberculous spondylodiscitis at the craniocervical junction revealed by signs of spinal cord compression, torticollis and dysphagia. The value of CT and MR imaging is discussed.

Adult↗
PubMed1987

[Suboccipital Pott's disease].

A new case of sub-occipital Pott's disease is reported: a 26 year old, coloured male patient from Senegal was admitted for: cervical pain of 6 month duration, neck stiffness, dysphagia, left XII paralysis and left hemiparesis. The radiological study found an anterior atlanto-axial subluxation, basilar impression, and increased thickness of the retropharyngeal soft tissue, lysis of the left occipital condyle and the left lateral mass. CT scan study revealed a retropharyngeal mass and an epidural contrast-enhanced lesion at the C2 C3 C4 levels. Chest-X ray showed one tuberculous lesion at the right apex. The research of Acid Fast Bacilli in gastric secretion samples and the results of the retropharyngeal mass puncture were positive. An antituberculous trichemotherapy was started. After early reduction by skull tongs traction, an occipito-cervical arthrodesis by Roy Camille plates was performed, followed by the wearing of a minerva plaster jacket and then a plastic collar. Each one for a 5 month period. One year later, there remained only a left XII paralysis, but the bony reconstruction was not yet obvious on tomography. A survey of the literature of 70 cases of sub-occipital Pott's disease has pointed out these findings: cervical pain (98%), neck stiffness (82%), Atlantoaxial subluxation (68%), thickened prevertebral soft tissue shadow (77%), lateral mass lysis (48%) other tuberculous focus (29%). The main therapeutic trends are: early and long-lasting antituberculous poly-chemotherapy, early reduction of subluxations, prolonged contention for slight osteolytic lesions and for major: lytic lesions, a posterior surgical procedure either by bone graft combined with wires or preferably fusion by means of occipito-cervical plates. The removal of abscess is discussed.

Adult↗