结核感染,它是由结核分枝杆菌(Mtb)引起的,最常见于呼吸系统患者。然而,它也可以定植其他组织,包括骨骼。在我们的案例中,一名77岁的白人男性在一次翻车机动车碰撞后出现颈部和下背部疼痛的主要投诉后出现在急诊科。经过临床改善和初步阴性检查,患者被认为稳定出院。四个月后,患者随后因背部疼痛恶化而入院,并在计算机断层扫描(CT)上进行了可疑的T9和T10椎间盘炎骨髓炎和脓肿形成的检查.在这次录取期间,脊髓Mtb在大约T9-T10时通过CT引导的左侧椎旁囊性集合的椎间盘间隙抽吸物的抗酸染色和实时聚合酶链反应得到证实.鉴于这些发现,患者随后接受了Mtb的标准四药治疗.我们的案例证明了在腰椎疼痛的诊断中考虑Pott病的重要性,特别是居住在国际移民和旅行较多地区的患者。
Tuberculosis infection, which is caused by the bacterium Mycobacterium tuberculosis (Mtb), most commonly manifests in patients with respiratory systems. However, it can also colonize other tissues including skeletal. In our
case, a 77-year-old Caucasian male presented to the emergency department following a rollover motor vehicle collision with chief complaints of neck and lower back pain. After clinical improvement and a preliminary negative workup, the patient was deemed stable for discharge. Four months later, the patient was subsequently admitted for worsening back pain with workup suspicious for T9 and T10 discitis osteomyelitis and abscess formation on computed tomography (CT). During this admission, spinal Mtb was confirmed by acid-fast stain and real-time polymerase chain reaction of a CT-guided disc space aspirate of a left paraspinal cystic collection at approximately T9-T10. Given these findings, the patient was subsequently put on standard four-drug therapy for Mtb. Our
case demonstrates the importance of considering Pott\'s disease in the diagnosis of lumbar spinal pain, especially in patients living in areas with high international migration and travel.