Vertebral tuberculosis revealed by thoracic manifestations. A study of five cases

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Spinal tuberculosis (Pott's disease) is common but rarely presents with thoracic symptoms.
• Thoracic manifestations can be the primary indicator of bone tuberculosis.

Purpose of the Study:

• To report radioclinical manifestations of Pott's disease revealed by thoracic symptoms.
• To describe diagnostic methods and treatment outcomes for spinal tuberculosis presenting atypically.

Main Methods:

• Retrospective study of five non-immunocompromised female patients over seven years.
• Analysis of clinical presentation, diagnostic imaging (CT, MRI), and histopathological/bacteriological confirmation.
• Review of treatment protocols and patient outcomes.

Main Results:

• Pott's disease accounted for 4.2% of extrapulmonary TB and 1.3% of all TB cases.
• Thoracic manifestations included paramediastinal shadows, chest wall abscesses, tuberculous empyema, and miliary shadows.
• Spinal imaging revealed monolevel (2 cases) or multilevel (3 cases) spondylitis; diagnosis confirmed via biopsy or extra-vertebral lesions.
• All patients had extra-vertebral tuberculosis; four treated successfully with 18-22 months of chemotherapy, one relapse.

Conclusions:

• Pott's disease can occur in non-immunocompromised patients and may be initially indicated by thoracic symptoms.
• Association with pulmonary lesions can aid diagnosis in lung disease departments.
• Multilevel spinal involvement is frequent, suggesting disseminated disease requiring a search for other extra-vertebral sites.