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Published on: November 19, 2019
Pott's disease
1Department of Pediatrics, Yüzüncü Yil University, Faculty of Medicine, Van, Turkey. huseyincaksen@hotmail.com
This case study highlights a challenging diagnosis of spinal tuberculosis in a young patient presenting with prolonged back pain and fever. Despite initial negative cultures, treatment with antituberculosis drugs led to symptom resolution, underscoring the importance of considering this diagnosis.
Area of Science:
- Pediatric Infectious Diseases
- Spinal Tuberculosis Diagnosis
- Medical Case Study
Background:
- Spinal tuberculosis (Pott's disease) can present insidiously, particularly in adolescents.
- Diagnostic challenges arise when initial microbiological tests are negative.
- Lumbago and fever are non-specific symptoms that can mask underlying infections.
Purpose of the Study:
- To present a case of spinal tuberculosis in a 15-year-old boy.
- To discuss the diagnostic difficulties encountered.
- To emphasize the role of empirical treatment in suspected cases.
Main Methods:
- Clinical presentation of a 15-year-old male with lumbago and fever.
- Comprehensive diagnostic workup including inflammatory markers, purified protein derivative test, and imaging.
- Bone biopsy for histopathological examination.
- Response to antituberculosis therapy.
Main Results:
- Elevated inflammatory markers (ESR 55 mm/hr, CRP 48 mg/L).
- Positive purified protein derivative (PPD) test (11 x 10 mm).
- Bone biopsy showed chronic active inflammation.
- No Mycobacterium tuberculosis was cultured from specimens.
- Significant clinical improvement after initiating antituberculosis drugs.
Conclusions:
- Spinal tuberculosis should be considered in the differential diagnosis of prolonged lumbago and fever in adolescents, even with negative initial cultures.
- Histopathological findings and clinical response to treatment can be crucial for diagnosis.
- Empirical antituberculosis therapy can be effective in suspected cases of spinal tuberculosis.
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