Presentación inusual de la enfermedad de Pott: reporte de un caso
A 63-year-old male was admitted with a 2-week-history of chest wall swelling with no accompanying symptoms, except for chronic lumbago. He had been diagnosed with bladder urothelial carcinoma and underwent transurethral-resection and BCG-instillation the year before. Physical examination and lab wor...
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Sociedade Galega de Medicina Interna
2025-01-01
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| Series: | Galicia Clínica |
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| Online Access: | https://galiciaclinica.info/publicacion.asp?f=4207 |
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| author | Ana Silva Rocha Marina Henriques Mendes |
| author_facet | Ana Silva Rocha Marina Henriques Mendes |
| author_sort | Ana Silva Rocha |
| collection | DOAJ |
| description | A 63-year-old male was admitted with a 2-week-history of chest wall swelling with no accompanying symptoms, except for chronic lumbago. He had been diagnosed with bladder urothelial carcinoma and underwent transurethral-resection and BCG-instillation the year before. Physical examination and lab work was unremarkable except for an ovaloid-lump of approximately 9cm on the anterior-left chest wall[Figure-1] and elevated C-reactive protein and erythrocyte-sedimentation-rate. A CT-scan revealed other abscesses: on the right cardiophrenic recess[Figure-2] and prevertebral at L4-L5 level[Figure-3]. MRI confirmed the diagnosis of spondylodiscitis[Figure-4]. HIV-serology was non-reactive, blood-cultures were negative, abscess’ pus was amicrobian but Ziehl–Neelsen stain and M.tuberculosis detection by molecular biology were positive. The diagnosis of Pott’s disease with multiple cold abscesses was stablished. Anti-tuberculosis treatment with isoniazid, rifampin, ethambutol and pyrazinamide was started. Surgical treatment was not considered due to his stability. He was discharged and referred to the national tuberculosis control program for continuation of treatment. On the follow-up consultation, within four weeks, he had clinical improvement[Figure-5].
Pott’s disease is a severe form of extrapulmonary tuberculosis, affecting vertebrae and intervertebral discs with potential to permanent neurological sequelae.1 It accounts for 2% of all tuberculosis cases, being the thoracolumbar column most commonly affected (80-90% of cases).1,2 The diagnosis tends to be delayed because of low degree of suspicion and nonspecific manifestations (such as lombalgia).1 Cold abscesses may be the first presentation and typically they are paravertebral thoracolumbar abscesses or localized over the chest wall. Early diagnosis and treatment are of utmost importance to ensure a good outcome.3 |
| format | Article |
| id | doaj-art-376a8264110e48a28456c632c88cb3d1 |
| institution | Kabale University |
| issn | 0304-4866 1989-3922 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Sociedade Galega de Medicina Interna |
| record_format | Article |
| series | Galicia Clínica |
| spelling | doaj-art-376a8264110e48a28456c632c88cb3d12025-01-14T11:59:30ZengSociedade Galega de Medicina InternaGalicia Clínica0304-48661989-39222025-01-01853353510.22546/74/42074207Presentación inusual de la enfermedad de Pott: reporte de un casoAna Silva Rocha0Marina Henriques Mendes1Centro Hospitalar Tâmega e SousaCentro Hospitalar Tâmega e SousaA 63-year-old male was admitted with a 2-week-history of chest wall swelling with no accompanying symptoms, except for chronic lumbago. He had been diagnosed with bladder urothelial carcinoma and underwent transurethral-resection and BCG-instillation the year before. Physical examination and lab work was unremarkable except for an ovaloid-lump of approximately 9cm on the anterior-left chest wall[Figure-1] and elevated C-reactive protein and erythrocyte-sedimentation-rate. A CT-scan revealed other abscesses: on the right cardiophrenic recess[Figure-2] and prevertebral at L4-L5 level[Figure-3]. MRI confirmed the diagnosis of spondylodiscitis[Figure-4]. HIV-serology was non-reactive, blood-cultures were negative, abscess’ pus was amicrobian but Ziehl–Neelsen stain and M.tuberculosis detection by molecular biology were positive. The diagnosis of Pott’s disease with multiple cold abscesses was stablished. Anti-tuberculosis treatment with isoniazid, rifampin, ethambutol and pyrazinamide was started. Surgical treatment was not considered due to his stability. He was discharged and referred to the national tuberculosis control program for continuation of treatment. On the follow-up consultation, within four weeks, he had clinical improvement[Figure-5]. Pott’s disease is a severe form of extrapulmonary tuberculosis, affecting vertebrae and intervertebral discs with potential to permanent neurological sequelae.1 It accounts for 2% of all tuberculosis cases, being the thoracolumbar column most commonly affected (80-90% of cases).1,2 The diagnosis tends to be delayed because of low degree of suspicion and nonspecific manifestations (such as lombalgia).1 Cold abscesses may be the first presentation and typically they are paravertebral thoracolumbar abscesses or localized over the chest wall. Early diagnosis and treatment are of utmost importance to ensure a good outcome.3https://galiciaclinica.info/publicacion.asp?f=4207tuberculosisespinalabscesoenfermedad de pottmycobacterium tuberculosis |
| spellingShingle | Ana Silva Rocha Marina Henriques Mendes Presentación inusual de la enfermedad de Pott: reporte de un caso Galicia Clínica tuberculosis espinal absceso enfermedad de pott mycobacterium tuberculosis |
| title | Presentación inusual de la enfermedad de Pott: reporte de un caso |
| title_full | Presentación inusual de la enfermedad de Pott: reporte de un caso |
| title_fullStr | Presentación inusual de la enfermedad de Pott: reporte de un caso |
| title_full_unstemmed | Presentación inusual de la enfermedad de Pott: reporte de un caso |
| title_short | Presentación inusual de la enfermedad de Pott: reporte de un caso |
| title_sort | presentacion inusual de la enfermedad de pott reporte de un caso |
| topic | tuberculosis espinal absceso enfermedad de pott mycobacterium tuberculosis |
| url | https://galiciaclinica.info/publicacion.asp?f=4207 |
| work_keys_str_mv | AT anasilvarocha presentacioninusualdelaenfermedaddepottreportedeuncaso AT marinahenriquesmendes presentacioninusualdelaenfermedaddepottreportedeuncaso |