A follow-up case of relapsing tuberculous spondylodiscitis, complicated with soft-tissues abscess and percutaneous fistula

Serbeze Kabashi-Muçaj, MD, PhD; Sefedin Muçaj, MD, PhD; Xhavid Gashi, MD; Kreshnike Dedushi-Hoti, MD, PhD; Jeton Shatri, MD, PhD; Dardan Dreshaj, MD; Flaka Pasha, MD

Radiology Case Reports (Mar 2022)

A follow-up case of relapsing tuberculous spondylodiscitis, complicated with soft-tissues abscess and percutaneous fistula

Serbeze Kabashi-Muçaj, MD, PhD,
Sefedin Muçaj, MD, PhD,
Xhavid Gashi, MD,
Kreshnike Dedushi-Hoti, MD, PhD,
Jeton Shatri, MD, PhD,
Dardan Dreshaj, MD,
Flaka Pasha, MD

Affiliations

Serbeze Kabashi-Muçaj, MD, PhD: Department of Radiology, University of Prishtina “Hasan Prishtina”, Prishtine, Republic of Kosovo; Clinic of Radiology, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo
Sefedin Muçaj, MD, PhD: National Institute of Public Health Str. Bulevardi i Dëshmorëve, nn 10000, Prishtine, Republic of Kosovo; Corresponding author. S. Mucaj: Boulevard ''Deshmoret e Kombit'' nn. 10000, Prishtine, Kosovo
Xhavid Gashi, MD: Department of Spinal Surgery, Clinic of Orthopedics, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo
Kreshnike Dedushi-Hoti, MD, PhD: Department of Radiology, University of Prishtina “Hasan Prishtina”, Prishtine, Republic of Kosovo; Clinic of Radiology, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo
Jeton Shatri, MD, PhD: Clinic of Radiology, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo
Dardan Dreshaj, MD: Head and Neck Surgery Clinic, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo
Flaka Pasha, MD: Clinic of Radiology, University Clinical Center of Kosovo, Prishtine, Republic of Kosovo; Department of Pharmacology and Toxicology and Clinical Pharmacology, University of Prishtina “Hasan Prishtina”, Prishtine, Republic of Kosovo

Journal volume & issue: Vol. 17, no. 3
pp. 563 – 568

Abstract

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Spinal tuberculosis (Pott's disease) is a frequent manifestation of Mycobacterium tuberculosis infection. It manifests as destruction of 2 or more adjacent vertebral bodies followed with destruction of the intervertebral disc, leading to a condition known as spondylodiscitis. Tuberculous spondylodiscitis represents with back pain, fever, joint stiffness, loss of spinal mobility, neurological symptoms, vertebral body collapse, gibbus formation and kyphosis. Persistent Pott's disease might lead to soft tissues abscesses, frequently involving iliopsoas muscle.We, herein, present a 20 years long follow-up case of a Pott's disease patient. The patient got diagnosed as tuberculous spondylodiscitis, almost 10 years after first symptoms onset. She underwent frequent computed tomography and magnetic resonance scanning, with spinal spondylodiscitis being its only significant finding, while lung parenchyma and other organs were not infected. Patient got treated with multidrug anti-tubercular regimen for 18 months in 2 different periods of time; nonetheless she complicated with iliopsoas muscle abscess and percutaneous fistula.Early diagnosis and treatment of spinal tuberculosis (TB) are of great importance in ensuring a good clinical outcome. Delaying the diagnosis and proper management can lead to spinal cord compression, deformity and irreversible neurological complications. Thus, multidrug anti-tubercular therapy must be started timely and the duration of anti-tubercular therapy needs to be individualized. The decision to terminate anti-tubercular therapy should be based on clinical, radiological, pathological and microbiological indices, rather than being based on specific guidelines.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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