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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
PubMed
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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.

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  • 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.