Introduction

Tuberculosis (TB) of the spine (Pott’s disease) is the most common site of bone infection in TB; hips and knees are also often affected.  The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected. 

Pathogenesis Of Pott’s Disease

Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary.  The infection then spreads from two adjacent vertebrae into the adjoining disc space.  If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage).  A dry soft tissue mass often forms and superinfection is rare.

Diagnosis of Pott’s disease

Clinical

The disease progresses slowly.  Signs and symptoms include:

Microbiology

Imaging

Management of Pott’s disease

Drug treatment is generally sufficient for Pott’s disease, with spinal immobilisation if required.  Surgery is required if there is spinal deformity or neurological signs of spinal cord compression.

Standard antituberculosis treatment is required.

Duration of antituberculosis treatment:

 

 Pathogenesis of Pott’s disease

Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary.  The infection then spreads from two adjacent vertebrae into the adjoining disc space.  If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage).  A dry soft tissue mass often forms and superinfection is rare.

 

Signs and symptoms by site of infection

Pulmonary TB

Fever, productive cough, anorexia, fatigue and night sweats.

Tuberculous meningitis

Headache (intermittent or persistent for 2–3 weeks). Confusion or other subtle changes in mental status. Fever may be low grade or absent. Patient may progress to coma over a few days or weeks.

Skeletal TB (most common is the spine; Potts’ disease)

Pain and stiffness which may lead to paralysis of the lower limbs.

Tubercular arthritis is usually a monoarthritis affecting primarily the hip or knee and less commonly the ankle, elbow, wrist and shoulder.

 Pott's disease

From Wikipedia, the free encyclopedia.

Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine. Precisely it is called tuberculous spondylitis and the original name was formed after Percivall Pott, a London surgeon. It is most commonly localized in the thoracic portion of the spine.

Common signs and symptoms are:

Diagnosis is based on:

Late complications of the disease are:

Treatment:

 

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 Tuberculosis (TB) has been around since the beginning of time but for the past decade has experienced an increasing prevalence. TB starts in the lungs but can travel to any organ or structure of the body. The vertebrae are the most often afflicted sites of extra- pulmonary lesions. Pott’s disease is the name given to TB of the spine. There are interventions that can enable a person with Pott’s disease to return to an optimal level of functioning, and nurses have a pivotal role in helping the patient attain that level. A case study with diagnostic findings and interventions is presented in this article.

 

 The objective of the study is to apply a new diagnostic method for Pott’s Disease, in less time and fewer major surgeries. The finality is to give the patient medical treatment to improve of the disease. Patient and method: Prospective study, descriptive, longitudinal, and observational with 32 patients, average age, 48 years (20-76 years). There were 17 males (58.12%) and 15 females (46.98%). The period covered June 1994 to June 1999, with selective judgement of the patient to be included in the study. The affected levels of Pott’s disease: Thoracic, 53%; lumbar, 28%, and thoracic lumbar, 19%. Diagnosis: we carried out in each patient a systemic study including the following: Laboratory: Bh, Baar in mucosity and urine; cultivation urine and mucosity; Immunological: PPD, ELISA for Ag Tb, Immunochromatography and PCR and Other: Rx, TAC on RNM. Relation of the study results:
• ELISA 15 patients (46%).
• Immunochromatography 12 patients (39%).
• PCR 4 patients (15%).
Treatment: Giving the patient medical treatment with antibiotics. The surgical treatment came later but in some cases depending of the indications made on anterior approach, the finality to was decompress and stabilize the column. The following review for 2-year evaluation, 12 months with antibiotic, and the release of a new chromatography to observation erradication and Rx. Discussion: We offer a diagnostic method that is more efficient and that avoids the complications that Pott’s Disease presents using the PCR and chromatography, and includes follow up of the patient. Evaluation of the eradication of the infection of Mycobacterium was carried out 12 months after the treatment.