Espondilitis tuberculosa ("Mal de Pott"): presentación de un caso y revisión bibliográfica / Tuberculous spondylitis (Pott's disease): case report and review of the literature

ABSTRACT

Tuberculosis of the spine (Pott' disease), is an uncommon evento of extrapulmonary tuberculosis and usually occurs in the absence of extraspinal infection. We report a 24 year-old-man assisted in Córdoba, City (Argentina). Patient arrived at the hospital with mild lumbar pain, thigh's hyperesthesia an patellar hyporreflexia, both in the right side, without general manifestations. X-ray and CT scanning showed severe structural domage of vertebral bodies of the fourth, an fifth lumbar (L4, L5) and first sacral (S1) vertebrae. In addition, paraspinal abscess with extension up to psoas muscle was observed. Mycobacterium tuberculosis was isolated by culture of specimens obtained by aspiration from affected area, fourty days after admission. Patient was treated for nine months with four drugs (Isoniazid, Rifampicine, Pyrazinamide and Ethambutol). Then, the spine was surgically stabilized. During a follw-up of ten years, patient improved progressively. We point out that Pott' disease should be suspected in all cases with vertebral osteomyelitis and negative bacteriological test for common bacteria.