Pott's disease: Difference between revisions
From WikiMD's Wellness Encyclopedia
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{{Infobox medical condition | {{Infobox medical condition | ||
| name | | name = Pott's disease | ||
| image | | image = [[File:Tuberculosis_spine_mummy.jpg|250px]] | ||
| caption | | caption = Mummy with evidence of Pott's disease | ||
| field | | field = [[Infectious disease]], [[Orthopedics]] | ||
| synonyms | | synonyms = Tuberculous spondylitis, Vertebral tuberculosis | ||
| symptoms | | symptoms = [[Back pain]], [[fever]], [[night sweats]], [[weight loss]], [[neurological deficits]] | ||
| complications | | complications = [[Spinal deformity]], [[paraplegia]], [[abscess formation]] | ||
| onset | | onset = Gradual | ||
| duration | | duration = Chronic | ||
| causes | | causes = [[Mycobacterium tuberculosis]] infection | ||
| risks | | risks = [[HIV/AIDS]], [[immunosuppression]], [[malnutrition]] | ||
| diagnosis | | diagnosis = [[MRI]], [[CT scan]], [[X-ray]], [[biopsy]] | ||
| differential | | differential = [[Pyogenic spondylitis]], [[Brucellosis]], [[Metastatic cancer]] | ||
| treatment | | treatment = [[Antitubercular therapy]], [[surgery]] | ||
| prognosis | | prognosis = Variable, depends on early diagnosis and treatment | ||
| frequency | | frequency = Rare in developed countries, more common in developing regions | ||
}} | }} | ||
Pott's disease is a rare, but a serious form of [[tuberculosis]] that is located in the [[spinal column]]. Segments of the spine may actually collapse. | Pott's disease is a rare, but a serious form of [[tuberculosis]] that is located in the [[spinal column]]. Segments of the spine may actually collapse.]] | ||
[[File:Naked woman with Pott's Disease (1904).jpg|alt=Lumbar Pott's disease|left|thumb|Lumbar Pott's disease]] | [[File:Naked woman with Pott's Disease (1904).jpg|left|thumb|alt=Lumbar Pott's disease|left|thumb|Lumbar Pott's disease]] | ||
== History == | == History == | ||
Tuberculosis (TB) is a disease that has been around for a long time but recently there has been an [https://www.ncbi.nlm.nih.gov/books/NBK538331/ increase in the developed nations] especially among the immunocompromised. | Tuberculosis (TB) is a disease that has been around for a long time but recently there has been an [https://www.ncbi.nlm.nih.gov/books/NBK538331/ increase in the developed nations] especially among the immunocompromised. | ||
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</youtube> | </youtube> | ||
== Cause == | == Cause == | ||
The pathogen causing the disease tuberculosis is Mycobacterium tuberculosis species although other species of the genus [[Mycobacterium]] can also cause it. | The pathogen causing the disease tuberculosis is Mycobacterium tuberculosis species although other species of the genus [[Mycobacterium]] can also cause it.]] | ||
[[File:CervicothoracicspinalTB-scan.png|alt=Cervicothoracicspinal TB-scan|left|thumb|Cervicothoracicspinal TB-scan]] | [[File:CervicothoracicspinalTB-scan.png|thumb|alt=Cervicothoracicspinal TB-scan|left|thumb|Cervicothoracicspinal TB-scan]] | ||
== Granulomatous inflammatory reaction == | == Granulomatous inflammatory reaction == | ||
The TB infection results in a granulomatous inflammatory reaction. | The TB infection results in a granulomatous inflammatory reaction. | ||
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* Specialized treatment for rheumatoid arthritis or Crohn’s disease | * Specialized treatment for rheumatoid arthritis or Crohn’s disease | ||
== Pathophysiology == | == Pathophysiology == | ||
Spinal tuberculosis is usually secondary to hematogenous spread from a primary site of infection such as [[lungs]]. | Spinal tuberculosis is usually secondary to hematogenous spread from a primary site of infection such as [[lungs]].]] | ||
[[File:Tuberculosis; spine of boy under care of Mr Pott Wellcome L0006118.jpg|alt=Tuberculosis; spine of boy|left|thumb|Tuberculosis; spine of boy]] | [[File:Tuberculosis; spine of boy under care of Mr Pott Wellcome L0006118.jpg|left|thumb|alt=Tuberculosis; spine of boy|left|thumb|Tuberculosis; spine of boy]] | ||
== Signs and symptoms == | == Signs and symptoms == | ||
Symptoms of TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as: | Symptoms of TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as: | ||
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== Cold abscess == | == Cold abscess == | ||
Tuberculosis can lead to what are called cold abscesses that typically lack all the inflammatory signs obvious in abscesses. | Tuberculosis can lead to what are called cold abscesses that typically lack all the inflammatory signs obvious in abscesses. | ||
Areas commonly affected include cervical spine, thoracic spine, and the lumbar spine. they may also form along psoas muscle, Petit's triangle, Scarpa's triangle, or the gluteal region. | Areas commonly affected include cervical spine, thoracic spine, and the lumbar spine. they may also form along psoas muscle, Petit's triangle, Scarpa's triangle, or the gluteal region.]] | ||
[[File:Tuberculosis symptoms.png|alt=Tuberculosis symptoms|left|thumb|Tuberculosis symptoms]] | [[File:Tuberculosis symptoms.png|thumb|alt=Tuberculosis symptoms|left|thumb|Tuberculosis symptoms]] | ||
== Spine deformity == | == Spine deformity == | ||
The clinical appearance of kyphotic deformity has been classified based on vertebrae involved as knuckle when only one vertebra was involved, gibbus when two vertebrae are involved and rounded kyphus when more than three vertebrae are involved. | The clinical appearance of kyphotic deformity has been classified based on vertebrae involved as knuckle when only one vertebra was involved, gibbus when two vertebrae are involved and rounded kyphus when more than three vertebrae are involved. | ||
== Neurological deficit == | == Neurological deficit == | ||
A neurological deficit can occur both during active and the healed stage secondary to mechanical traction over the internal gibbus or spinal instability. | A neurological deficit can occur both during active and the healed stage secondary to mechanical traction over the internal gibbus or spinal instability.]] | ||
[[File:Tuberculosis spine mummy.jpg|left|thumb|alt=Tuberculosis spine mummy|left|thumb|Tuberculosis spine mummy]] | |||
== Diagnosis == | == Diagnosis == | ||
There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests. | There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests.''' A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease. | ||
If a person is found to be infected with TB bacteria, other tests are needed to see if the person has latent TB infection or TB disease. THe gold standard test is culture of the [[mycobacterium tuberculosis]] | If a person is found to be infected with TB bacteria, other tests are needed to see if the person has latent TB infection or TB disease. THe gold standard test is culture of the [[mycobacterium tuberculosis]] | ||
== Other tests == | == Other tests == | ||
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* ''[[Mantoux test]]'' | * ''[[Mantoux test]]'' | ||
* ''Interferon-gamma release assay'' | * ''Interferon-gamma release assay'' | ||
* ''Whole blood-based enzyme-linked immunosorbent assay (ELISA)'' | * ''Whole blood-based enzyme-linked immunosorbent assay (ELISA)'']] | ||
[[File:201708 Mycobacterium tuberculosis.svg|alt=Mycobacterium tuberculosis|left|thumb|Mycobacterium tuberculosis]] | [[File:201708 Mycobacterium tuberculosis.svg|thumb|alt=Mycobacterium tuberculosis|left|thumb|Mycobacterium tuberculosis]] | ||
== Treatment == | == Treatment == | ||
Treatment decisions should be made in consultation or by the [[infectious disease]] specialists. | Treatment decisions should be made in consultation or by the [[infectious disease]] specialists. | ||
TB disease can be treated by taking several drugs for 6 to 9 months. | TB disease can be treated by taking several drugs for 6 to 9 months.''' There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are: | ||
* [[isoniazid]] (INH) | * [[isoniazid]] (INH) | ||
* [[rifampin]] (RIF) | * [[rifampin]] (RIF) | ||
Latest revision as of 04:27, 14 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's medical weight loss NYC, sleep center NYC
Philadelphia medical weight loss and Philadelphia sleep clinics
| Pott's disease | |
|---|---|
| File:Tuberculosis spine mummy.jpg | |
| Synonyms | Tuberculous spondylitis, Vertebral tuberculosis |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Back pain, fever, night sweats, weight loss, neurological deficits |
| Complications | Spinal deformity, paraplegia, abscess formation |
| Onset | Gradual |
| Duration | Chronic |
| Types | N/A |
| Causes | Mycobacterium tuberculosis infection |
| Risks | HIV/AIDS, immunosuppression, malnutrition |
| Diagnosis | MRI, CT scan, X-ray, biopsy |
| Differential diagnosis | Pyogenic spondylitis, Brucellosis, Metastatic cancer |
| Prevention | N/A |
| Treatment | Antitubercular therapy, surgery |
| Medication | N/A |
| Prognosis | Variable, depends on early diagnosis and treatment |
| Frequency | Rare in developed countries, more common in developing regions |
| Deaths | N/A |
Pott's disease is a rare, but a serious form of tuberculosis that is located in the spinal column. Segments of the spine may actually collapse.]]
History[edit]
Tuberculosis (TB) is a disease that has been around for a long time but recently there has been an increase in the developed nations especially among the immunocompromised.
Cause[edit]
The pathogen causing the disease tuberculosis is Mycobacterium tuberculosis species although other species of the genus Mycobacterium can also cause it.]]
Granulomatous inflammatory reaction[edit]
The TB infection results in a granulomatous inflammatory reaction.
Risk factors[edit]
- Some known risk factors for TB include:
- Prolonged exposure to an infected person
- Overcrowding
- Substance abuse
- Diabetes mellitus
- Silicosis
- Cancer of the head or neck
- Leukemia or Hodgkin’s disease
- Severe kidney disease
- Low body weight
- Certain medical treatments (such as corticosteroid treatment or organ transplants)
- Specialized treatment for rheumatoid arthritis or Crohn’s disease
Pathophysiology[edit]
Spinal tuberculosis is usually secondary to hematogenous spread from a primary site of infection such as lungs.]]
Signs and symptoms[edit]
Symptoms of TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as:
- a bad cough that lasts 3 weeks or longer
- pain in the chest
- coughing up blood or sputum (phlegm from deep inside the lungs)
- Other symptoms of TB disease are
- weakness or fatigue
- weight loss
- no appetite
- chills
- fever
- sweating at night
Cold abscess[edit]
Tuberculosis can lead to what are called cold abscesses that typically lack all the inflammatory signs obvious in abscesses. Areas commonly affected include cervical spine, thoracic spine, and the lumbar spine. they may also form along psoas muscle, Petit's triangle, Scarpa's triangle, or the gluteal region.]]
Spine deformity[edit]
The clinical appearance of kyphotic deformity has been classified based on vertebrae involved as knuckle when only one vertebra was involved, gibbus when two vertebrae are involved and rounded kyphus when more than three vertebrae are involved.
Neurological deficit[edit]
A neurological deficit can occur both during active and the healed stage secondary to mechanical traction over the internal gibbus or spinal instability.]]
Diagnosis[edit]
There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests. A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease. If a person is found to be infected with TB bacteria, other tests are needed to see if the person has latent TB infection or TB disease. THe gold standard test is culture of the mycobacterium tuberculosis
Other tests[edit]
- Plain radiographs
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Nuclear imaging: 18 F-fluorodeoxyglucose (18F-FDG) labeled positron emission tomography (PET) scan
Laboratory Tests
- Erythrocyte sedimentation rate (ESR)
- Serological tests for IgG and IgM antibody levels against TB antigen
- Acid-fast bacilli (AFB) staining
- TB culture
- Molecular testing and polymerase chain reaction (PCR)
- Gene Xpert MTB/RIF
- Histopathological evaluation
Tests to Detect Latent Tuberculosis
- Mantoux test
- Interferon-gamma release assay
- Whole blood-based enzyme-linked immunosorbent assay (ELISA)]]
Treatment[edit]
Treatment decisions should be made in consultation or by the infectious disease specialists. TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are:
- isoniazid (INH)
- rifampin (RIF)
- ethambutol (EMB)
- pyrazinamide (PZA)
MDR TB[edit]
Multi-drug resistant TB, or MDR-TB, is defined as TB infection resistant to INH and rifampicin
Complications[edit]
TB of the spine with destruction of vertebrae can lead to changes in curvature of the spine
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