SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The incidence of tuberculosis among patients undergoing antirejection therapy is considerably higher than in the general population. Heart transplant recipients have been found to carry the highest risk of tuberculosis. There are no reported data about Pott's disease in heart transplant recipients. The authors present a case of Pott's disease seen after heart transplantation (HTx).
One hundred and seventy-one patients suffering from Pott's disease of the spine were treated by the same surgeons between 1965 and 1985. Chemotherapy, which varied during the period, was given in every case. Plaster immobilization was only used in the first 41 patients, until the authors concluded that it did not prevent worsening of the kyphosis. For technical reasons, surgical treatment was not used in any of these 171 patients. The results showed, in children, not only the usual development of kyphosis in the course of treatment but worsening later in the course of growth. For this reason, arthrodesis by the anterior route should be considered to obtain early fusion when the facilities and technical skills are available. In adults, the indications for surgery are more limited. Whilst there is a risk that kyphosis may reach a mean of 20 degrees during conservative treatment, it does not increase later. The authors conclude that it is necessary to link the indications for surgery to the availability of facilities at each individual hospital called upon to treat these patients.
BACKGROUND: Radiological investigations are central in the diagnosis and management of TB spine. In Ghana there is a dearth of literature on the disorder. This paper seeks to describe the CT features of the bony and soft tissue changes in Pott's disease. METHOD: It is a descriptive report of the CT scans performed on 30 patients with proven Pott's disease from January 1998 to December 2000 at the Korle Bu Teaching Hospital Accra, Ghana. RESULTS: The disorder was common among children and young adults (76.7%). Chronic back pain was the frequent presenting complain (53.3%). The dorsal spine remains the site of preference while T11 recorded the highest incidence (73.3%). The vertebral body was destroyed in all the cases and the fragmentary type of bone destruction was the common observation. The incidence of cord compression demonstrated by CT was high (73.3%). Other findings were paraspinal and epidural masses observed in (66.7%) and (73.3%) respectively. CONCLUSION: CT images demonstrated the spinal level of destruction. Improved resolution also showed detailed changes within the outlined soft tissue masses, facilitating early diagnosis and prompt initiation of therapy.
Extrapulmonary tuberculosis is more common in end-stage renal disease than in normal subjects, and it frequently poses both diagnostic and therapeutic challenges. We describe 2 dialysis patients with tuberculosis of the spine (Pott's disease). The 1st patient presented with back and left hip pain, low-grade fever, left-quadriceps weakness, hypoesthesia of the left thigh, and hypoactive left-knee jerk. X-rays of the spine showed only osteophytes. Magnetic resonance imaging showed increased signal intensity of L3 with focal expansion into the spinal canal. A computerized tomography guided biopsy revealed granulomas, and Ziehl-Neelsen stain was positive. Therapy with rifampin, isoniazid, ethambutol, and pyrazinamide caused peripheral neuropathy and optic neuritis. The 2nd patient developed bilateral proximal thigh pain and weakness that progressed to paraplegia. Magnetic resonance imaging showed destructive lesion of L3-5, involving both psoas muscles, prevertebral space, and neural foramina. Ziehl-Neelsen stain of the biopsy specimen was negative, but culture was positive for Mycobacterium tuberculosis. Paraplegia improved only partially after 1 year of therapy. Pott's disease should be suspected in end-stage renal disease patients with back pain and/or neuromuscular complaints, particularly in those who immigrated from Asian and Latin-American countries. Treatment of tuberculosis in dialysis patients may cause significant morbidity.
Tuberculosis (TB) has been around since the beginning of time but for the past decade has experienced an increasing prevalence. TB starts in the lungs but can travel to any organ or structure of the body. The vertebrae are the most often afflicted sites of extra-pulmonary lesions. Pott's disease is the name given to TB of the spine. There are interventions that can enable a person with Pott's disease to return to an optimal level of functioning, and nurses have a pivotal role in helping the patient attain that level. A case study with diagnostic findings and interventions is presented in this article.
The authors present a case of cervical Pott's disease with severe neurological impairment and with a favourable course with medical and surgical treatment. The diagnostic difficulties and the possibilities of treatment at the present stage are discussed.
The authors report one case of cervical Pott's disease located in C5 and associated with neurological disorders. Following corrections of the spinal disaxation, they advocate a per priman posterior fixation which will ensure spinal stability. This will be followed secondarily by an operation through an anterior approach.
Spinal tuberculosis with paraplegia, although decreasing in incidence, remains a problem in certain sections of the United States and in most underdeveloped nations. Evacuations of the tuberculous abscess, debridement of necrotic bone, and fusion of the anterior spine are maneuvers performed increasingly by thoracic surgeons. Twenty-two patients with Pott's disease and symptoms of back pain, gibbous deformity, and neurological deficit underwent thoracotomy. Nine were paraplegic prior to operation. Postoperatively, spinal fusion occurred in all cases. All paraplegic patients can walk now, and 17 of the 22 treated operatively have been completely rehabilitated and are in school or working. The average hospital stay was 2.4 months. There was 1 operative death. Medical treatment for Pott's disease consisted of bed rest and chemotherapy and resulted in progressive neurological deficit in 2 patients with an average hospital stay of 2.2 years. We believe operative treatment offers two distinct advantages: excellent reversal of even long-standing paraplegia and markedly shortened hospital stay.
In a high tuberculosis TB prevalence country, mortality due to miliary TB is not unknown but the treatment outcome in general is good. We describe a previously healthy man with miliary TB who did not respond to 2-months antituberculous therapy with 4 drugs. Persistent complaints of backache, which antedated chest symptoms, resulted in a diagnosis of Pott's disease. Culture of bronchial aspirate yielded multidrug resistant Mycobacterium tuberculosis that responded slowly to streptomycin, ethionamide, cycloserine, clofazimine, ofloxacin, paraaminosalicylic acid and isoniazid. The association of multidrug resistant miliary TB with Pott's disease in an immunocompetent patient is yet to be highlighted.
The first reported case of a patient with BCG-induced Pott's disease following immunotherapy for melanoma is presented. No signs or symptoms of the disease were detected for 2 1/2 years after therapy. The diagnosis and treatment of this complication of melanoma therapy are discussed.
We report a case of a surgical treatment with anterior instrumentation in tuberculous spondylitis (Pott's disease), in a 71 years old woman, that was in treatment for pulmonary tuberculosis, with lumbar pain, progressive disability to walk, kyphotic deformity and vesical dysfunction. Magnetic resonance image presents a lesion in the bodies of T12 and L1, with paravertebral abscess. The patient was treated surgically by transthoracic-abdominal approach. The vertebral bodies were cut off and the spine were instrumented anteriorly with a mesh cage and a Z plate. This procedure permits a good arthrodesis and a immediately stabilization of the spine, without any complication of the infection. The patient was seen a year after the surgery and is free of infection, without motor deficit, pain or reminiscent kyphosis.
Two young children suffering from acute thoracic kyphosis due to vertebral tuberculosis (Pott's disease) are described. One patient presented with recent onset spastic paraplegia due to cord compression. Anterior decompression and stabilization with a vascularized rib strut graft was performed in both patients. The neurological recovery in the compromised patient was remarkable; spinal stability was achieved in both patients, thus avoiding the necessity for a posterior spinal fusion.
Explore the source record for details and available documents.
A 68 year-old woman presented with a spinal cord compression from an angular kyphosis due to Pott's disease at age 7. Clinical, radiological and pathological studies of the vertebral lesions did not demonstrate an evolutive lesion. However, culture yielded some viable Koch's bacilli. This bacteriologic confirmation 61 years later exemplifies the importance of host immunity reactions, that may prevent the development of KB, and the remarkable capacity of survival of the bacillus.
The author presents a case of tuberculosis inflammation of thoracic vertebra with cold abcess along the spinal column, Pott's disease, in a woman 42 years old, a worker, with subjective difficulties which had lasted over a year before the diagnosis was made. TBC lungs and other localities was in regression in the last 30 year, it was even thought overhauled. But in recent times because of great migrations of the population and the fall of personal and social standards growth of new cases as well as revival of the old ones has been observed. Hard cases of lung tuberculosis in the first place and then of other localities have been diagnosed sporadically since fluorography has not been done for a longer time due to wellknown reasons. The reasons for making diagnoses in the terminal phase of the shown case are the instilled manner and opinion of the physicians belonging to previous peaceful times that tuberculosis has been overhauled, so that now many of them react inertly about this disease. The author wants this review to be seen inside the actual conditions of life, work, nutrition, hygiene, health care possibilities and health care.
Explore the source record for details and available documents.