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Case Reports
. 2016 Jun 7:17:384-8.
doi: 10.12659/ajcr.897555.

A Rare Case of Pott's Disease (Spinal Tuberculosis) Mimicking Metastatic Disease in the Southern Region of Denmark

Azra Osmanagic  1 , Amir Emamifar  2 , Jacob Christian Bang  3 , Inger Marie Jensen Hansen  2
Affiliations
Case Reports

A Rare Case of Pott's Disease (Spinal Tuberculosis) Mimicking Metastatic Disease in the Southern Region of Denmark

Azra Osmanagic et al. Am J Case Rep. .

Abstract

Background: Pott's disease (PD) or spinal tuberculosis is a rare condition which accounts for less than 1% of total tuberculosis (TB) cases. The incidence of PD has recently increased in Europe and the United States, mainly due to immigration; however, it is still a rare diagnosis in Scandinavian countries, and if overlooked it might lead to significant neurologic complications.

Case report: A 78-year-old woman, originally from Eastern Europe, presented to the emergency department with a complaint of nausea, vomiting, weight loss, and severe back pain. On admission she was febrile and had leukocytosis and increased C-reactive protein. Initial spinal x-ray was performed and revealed osteolytic changes in the vertebral body of T11 and T12. Magnetic resonance imaging (MRI) of the spine illustrated spondylitis of T10, T11, and T12, with multiple paravertebral and epidural abscesses, which was suggestive of PD. Polymerase chain reaction (PCR) of the patient's gastric fluid was positive for Mycobacterium tuberculosis (MT). Based on MRI and PCR findings, standard treatment for TB was initiated. Results of the spine biopsy and culture showed colonies of MT and confirmed the diagnosis afterwards. Due to the instability of the spine and severe and continuous pain, spine-stabilizing surgery was performed. Her TB was cured after nine months of treatment.

Conclusions: PD is an important differential diagnosis of malignancy that should be diagnosed instantly. History of exposure to TB and classic radiologic finding can help make the diagnosis.

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Figures

Figure 1.
Figure 1.
Chest x-ray shows no signs of tuberculosis.
Figure 2.
Figure 2.
Destruction of T10–T12 plus edematous intervertebral discs resulted in anterior collapse, multiple anterior and lateral paravertebral and epidural abscesses with a thin, contrast-enhanced membrane in a patient with Pott’s disease.
See this image and copyright information in PMC

References

    1. Turgut M. Spinal tuberculosis (Pott’s disease): Its clinical presentation, surgical management, and outcome. A survey study on 694 patients. Neurosurg Rev. 2001;24:8–13. - PubMed
    1. Kaila R, Malhi AM, Mahmood B, Saifuddin A. The incidence of multiple level noncontiguous vertebral tuberculosis detected using whole spine MRI. J Spinal Disord Tech. 2007;20:78–81. - PubMed
    1. Colmenero JD, Jiménez-Mejías ME, Reguera JM, et al. Tuberculous vertebral osteomyelitis in the new millennium: Still a diagnostic and therapeutic challenge. Eur J Clin Microbiol Infect Dis. 2004;23:477–83. - PubMed
    1. Weng CY, Chi CY, Shih PJ, et al. Spinal tuberculosis in non-HIV-infected patients: 10 year experience of a medical center in central Taiwan. J Microbiol Immunol Infect. 2010;43:464–69. - PubMed
    1. Johansen IS, Nielsen SL, Hove M, et al. Characteristics and clinical outcome of bone and joint tuberculosis from 1994 to 2011: A retrospective register-based study in Denmark. Clin Infect Dis. 2015;61:554–62. - PubMed

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