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At least 19 recordsLinked to original sources

[Pott disease in the differential diagnosis of low back pain].

Tuberculosis of skeletal system is frequently located in spine and is called as "Pott disease". Pott disease is frequently located in lumbar vertebrates and it can be interfered with the other diseases which cause low back pain. Our patient which was operated because of breast cancer nearly 10 years ago, has had waist and leg pain for 6 weeks. The story of breast cancer reminded us the possibility of a metastasis. But there were no findings in favour of metastasis except the high scores of sedimentation rate. There was a disc herniation according to the MR imaging of lumbar region. Therefore we performed epidural steroid injection but 10 days later the patient was unable to walk. We present this case to understand the importance of the differential diagnosis of Pott disease.

Aged↗

The role of anterior spinal instrumentation and allograft fibula for the treatment of pott disease.

STUDY DESIGN: The authors retrospectively reviewed 28 patients with multilevel Pott disease who underwent anterior radical débridement, decompression, and fusion with anterior spinal instrumentation and fibular allograft replacement. OBJECTIVES: To assess the efficacy of allograft fibular fusion and anterior spinal stabilization as an alternative treatment of spinal tuberculosis. SUMMARY OF BACKGROUND DATA: The results of anterior surgery in preventing late or early spinal deformity from Pott disease have been closely related to the status of the segmental stability and graft materials, especially in cases of multisegmental involvement. The use of allograft and anterior spinal instrumentation in tuberculous spondylitis remains controversial because of the risk of persistence and recurrence of infection in the presence of devitalized bone graft, which may also be prone to poor incorporation. METHODS: Between 1993 and 1998, a total of 28 patients with Pott disease (two or more segments involved) underwent anterior débridement, allograft fusion, and stabilization. The patients were given antituberculosis treatment in the postoperative period according to a standardized protocol. The authors retrospectively analyzed their experience in tuberculous spondylitis, with particular attention to method, allograft incorporation, and anterior spinal instrumentation. Incorporation of the allograft was evaluated by either static or dynamic (flexion/extension) radiographs. RESULTS: None of the patients used external support in the postoperative period. A minimum of 3 years' follow-up was achieved in 26 patients. The overall fusion rate was 96%. There were no graft problems. Two patients died in the early postoperative period as a result of multiorgan failure. One patient suffered from an instrumentation failure. No other complications were observed. The segmental correction was maintained successfully in all of the patients. The mean correction loss was 6 degrees. CONCLUSION: The use of anterior spinal stabilization accompanied with a structural allograft fibula is effective after proper radical débridement for interbody fusion, deformity correction, and maintenance in cases of multisegment-involved Pott disease.

Adult↗

Two cases of pott disease associated with bilateral psoas abscesses: case report.

STUDY DESIGN: Two case reports and a literature review of spinal osteomyelitis with bilateral psoas abscesses secondary to Mycobacterium tuberculosis. OBJECTIVE: Describe the presentation, diagnosis, treatment, and outcome of spinal tuberculosis (i.e., Pott disease). SUMMARY OF BACKGROUND DATA: Pott disease is a well-known condition in unindustrialized countries causing multiple spinal deformities in children. However, its association with bilateral psoas abscesses in adults with minimal risk factors is not commonly recognized in industrialized countries. METHODS: There are 2 adult cases of Pott disease with psoas abscesses presented, and the relevant literature is reviewed. Plain spine radiographs, spine magnetic resonance imaging (MRI), routine bacterial and acid-fast bacilli cultures of infected material, and other diagnostic testing for M. tuberculosis were performed. RESULTS: Plain radiographs and MRI of the spine showed vertebral osteomyelitis with compression fractures, and MRI also revealed bilateral psoas abscesses. Acid-fast bacilli culture and other M. tuberculosis diagnostic testing of psoas abscess specimens confirmed the diagnosis of M. tuberculosis. CONCLUSION: Although spinal osteomyelitis with psoas abscess is classically associated with Staphylococcus aureus infection, Pott disease should be considered in this clinical setting, and risk factor assessment and testing for tuberculosis should be performed.

Aged, 80 and over↗

Asymptomatic retropharyngeal abscess related to cervical Pott's disease.

Pott's disease is an uncommon manifestation of tuberculosis, which usually involves thoracic or lumbar vertebrae. The body of the vertebrae is most severely affected and a compression fracture is an almost inevitable consequence of the disease. A paravertabral abscess generally accompanies vertebral involvement. Tenderness over the involved vertebrae, weakness of the related muscles, and paraesthesia are the usual symptoms. In this article, we report a case of cervical Pott's disease presenting mainly with neurologic symptoms such as weakness, pain, numbness of both arms and hands, and an asymptomatic retropharyngeal abscess.

Biopsy, Fine-Needle↗

Mycobacterium tuberculosis chaperonin 10 stimulates bone resorption: a potential contributory factor in Pott's disease.

Pott's disease (spinal tuberculosis), a condition characterized by massive resorption of the spinal vertebrae, is one of the most striking pathologies resulting from local infection with Mycobacterium tuberculosis (Mt; Boachie-Adjei, O., and R.G. Squillante. 1996. Orthop. Clin. North Am. 27:95-103). The pathogenesis of Pott's disease is not established. Here we report for the first time that a protein, identified by a monoclonal antibody to be the Mt heat shock protein (Baird, P.N., L.M. Hall, and A.R.M. Coates. 1989. J. Gen. Microbiol. 135:931-939) chaperonin (cpn) 10, is responsible for the osteolytic activity of this bacterium. Recombinant Mt cpn10 is a potent stimulator of bone resorption in bone explant cultures and induces osteoclast recruitment, while inhibiting the proliferation of an osteoblast bone-forming cell line. Furthermore, we have found that synthetic peptides corresponding to sequences within the flexible loop and sequence 65-70 of Mt cpn10 may comprise a single conformational unit which encompasses its potent bone-resorbing activity. Our findings suggest that Mt cpn10 may be a valuable pharmacological target for the clinical therapy of vertebral tuberculosis and possibly other bone diseases.

Amino Acid Sequence↗

Craniovertebral junction Pott's disease.

Pott's disease of the craniovertebral junction is extremely rare. The authors studied the immediate and long-term outcome after transoral decompression, occipitocervical stabilization with fusion and antitubercular therapy (ATT) in patients who had neurological deficits due to craniovertebral junction (CVJ) tuberculosis. This is a retrospective study of the management and outcome in 10 consecutive patients in whom features of spinal cord (with or without) compression were observed, and CVJ tuberculosis was diagnosed in two different neurological departments between 1990 and 2002. They ranged in age from 15 to 72 years. The onset of symptoms was either acute or subacute. Patients presented with neck and occipital pain (90%), progressive tetraparesia (40%), sensory symptoms (40%), neck stiffness (30%) and urinary dysfunction (20%). The disease caused spinal cord compression in six patients, atlantoaxial dislocation in five patients, basilar impression in one and upper vertebral column destruction without dislocation in three. Two patients presented with multiple spinal tuberculosis. Antitubercular therapy was used in all cases for 15 months. Surgical treatment performed in all patients. Four patients underwent transoral drainage of retropharyngeal abscess with granulation tissue and one odontoidectomy. Six patients then underwent occipitocervical (occiput -C3 or -C4) fusion with insertion of titanium plate and screw. Postoperatively, ATT was prescribed for 15 months. At long-term follow-up (median 50.2 months), functional status considerably improved. Two patients died 2 months later due to myocardial infarction. Patients with CVJ with features of cervical myelopathy are ideally treated with transoral decompressive procedures followed by occipitocervical fusion, because this therapy provides immediate neurological improvement, stability and allows early mobilization. The long-term prognosis in patients with this disease is excellent, provided it is treated with appropriate surgical intervention and with adequate duration of ATT. This approach provides excellent access to this region, with a low operative morbidity and no mortality.

Adolescent↗

Pott disease in the thoracolumbar spine with marked kyphosis and progressive paraplegia necessitating posterior vertebral column resection and anterior reconstruction with a cage.

STUDY DESIGN: Case report. OBJECTIVES: To report on a patient with Pott disease, progressive neurologic deficit, and severe kyphotic deformity, who had medical treatment fail and required posterior/anterior decompression with instrumented fusion. Treatment options will be discussed. SUMMARY OF BACKGROUND DATA: Tuberculous spondylitis is an increasingly common disease worldwide, with an estimated prevalence of 800,000 cases. METHODS: Surgical treatment consisting of extensive posterior decompression/instrumented fusion and 3-level posterior vertebral column resection, followed by anterior debridement/fusion with cage reconstruction. RESULTS: Neurologic improvement at 6-month follow-up (Frankel B to Frankel D), with evidence of radiographic fusion. CONCLUSIONS: A 70-year-old patient with progressive Pott paraplegia and severe kyphotic deformity, for whom medical treatment failed is presented. A posterior vertebral column resection, multiple level posterior decompression, and instrumented fusion, followed by an anterior interbody fusion with cage was used to decompress the spinal cord, restore sagittal alignment, and debride the infection. At 6-month follow-up, the patient obtained excellent pain relief, correction of deformity, elimination of the tuberculous foci, and significant recovery of neurologic function.

Aged↗

[Pott disease: current diagnostic and therapeutic approaches].

Spinal tuberculosis, or Pott's disease, has been known since ancient times; it was a common orthopaedic illness until 1950, but the progress of specific therapies confined it to third word countries; its resurgency in recent years in developed countries is due to drug resistance, immigration from endemic areas, and an increase in immunodeficient patients. Spinal disease is found in about 1% of all tuberculosis cases. Modern treatment consists of a diagnostic phase, based on clinical findings and imaging exams, and of a medical and surgical therapy. Our patients have been treated with a three antibiotic drugs scheme, and underwent early surgical treatment, in order to assure the curettage of the lesion and obtain spine stabilization, so as to avoid spinal deformity.

Humans↗

Recurrent invasive intraductal papillary mucinous carcinoma of the pancreas mimicking pott disease: review of the literature.

Specific information regarding intraductal papillary mucinous neoplasm (IPMN) recurrence is limited because most series are small and the follow-up interval is short. We report an unusual case of cancer recurrence in an 86-year-old woman who had undergone a pancreaticoduodenectomy for a large IPMN in the head of the pancreas. Final pathological evaluation of the resected pancreas found a component of in situ and invasive ductal adenocarcinoma without lymph node involvement. The patient did not receive postoperative chemotherapy and was monitored with transaxial imaging at regular intervals. Nine years later, the patient developed a retroperitoneal psoas abscess that was misdiagnosed as tuberculous spondylitis (Pott disease) but was proven to be recurrent mucinous adenocarcinoma of pancreatic origin. In our review of published reports in patients who underwent resection of IPMN, we found a combined mean recurrence rate of approximately 20%.

Adenocarcinoma, Mucinous↗

Pott's disease before Pott.

Pott's disease, i.e. caries of the spine with gibbosity, psoas abscesses and palsy, has been known since antiquity, its relation with tuberculosis suspected, as is seen in the Hippocratic writings. In the 18th century cases were studied in France and England; in the Netherlands by Hovius, Camper, Bonn and Coopmans. The most lucid descriptions however were those of SIR PERCIVALL POTT (1779). An annotated Dutch translation by DU PUI (1779) called attention to the treatment of this disease which was on the increase. In retrospect the eponym 'Pott's disease' seems well deserved.

History, 16th Century↗

[Tuberculous spondylitis--Pott disease--in a 33-year-old man from Greenland].

We report a case where tuberculous spondylitis was diagnosed in a 33-year-old man from Greenland. Very typically for Pott's disease, there was back pain, weight loss, and a characteristic kyphotic deformity. Computed tomography showed destruction of the thoracic vertebrae with paraspinal abscesses. The treatment was antituberculous therapy and surgery.

Adult↗

Multiple metastatic tuberculosis abscesses in a patient with Pott disease and lung tuberculosis: a case report.

The incidence of tuberculosis in Western countries is rising, and continued vigilance together with an awareness of its protean manifestations is essential. Cutaneous tuberculosis is a relatively rare manifestation of the disease, accounting for only 1% of extrapulmonary cases of tuberculosis and 0.14% of all reported cases of tuberculosis. A 19-year-old male patient was admitted to our clinic with skin lesions both at the front and at the back of his body. With clinical findings, histopathology, polymerase chain reaction, PA lung graph, and computerised tomography, the patient was diagnosed with metastatic tuberculosis abscess associated with lung tuberculosis and Pott's disease. Antituberculosis drugs were administered. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasing common skin disorder.

Abscess↗