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[Sacral tuberculous osteitis]
J C Meurice1, P Dore, F Lamotte
1Service de Pneumologie, Centre Hospitalier Universitaire de Poitiers.
Revue Des Maladies Respiratoires
|January 1, 1994
Summary
A rare case of isolated sacral tuberculosis in a child caused sudden leg paralysis. Recurrent presacral abscesses highlight treatment challenges in this unusual bony tuberculosis presentation.
Area of Science:
- Pediatric infectious diseases
- Skeletal tuberculosis
- Medical case reports
Background:
- Tuberculosis (TB) typically affects the lungs, but can manifest in other sites.
- Isolated bony tuberculosis, particularly in the sacrum, is exceptionally rare in children.
- Bacille Calmette-Guérin (BCG) vaccination is common but does not always prevent TB reactivation or unusual presentations.
Observation:
- A 5-year-old child presented with acute, complete loss of function in the left leg.
- Imaging revealed an isolated sacral lesion consistent with tuberculosis.
- A presacral abscess recurred nine months after initial anti-tuberculous treatment.
Findings:
- The sacral tuberculosis was successfully treated with anti-tuberculous drugs.
- Despite treatment, a presacral abscess recurred, indicating potential challenges in complete eradication.
- The patient was HIV-negative and BCG-vaccinated, making the isolated sacral TB presentation more noteworthy.
Implications:
- This case underscores the importance of considering unusual sites for tuberculosis in pediatric differentials.
- Recurrence of presacral abscesses suggests the need for prolonged or modified treatment strategies for bony TB.
- Further research into the management of rare skeletal TB presentations in immunocompetent children is warranted.