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Two Children With Spinal Tuberculosis Associated With Psoas Abscess

Keywords: Spinal tuberculosis , psoas abscess , vertebral biopsy

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Abstract:

Pott disease is a well-known condition in developing countries causing multiple spinal deformities in children. The disease may be difficult to diagnose clinically because of its rarity, insidious onset and nonspecific clinical presentation. We report two pediatric cases of spinal tuberculosis. One was a 3-year-old girl who presented with a flank mass. Another, an 11-year-old boy, was admitted with thoracolumbar back pain and kyphosis. Magnetic resonance imaging (MRI) revealed a psoas abscess almost completely replacing the left psoas muscle in both patients. Computed tomography-guided needle biopsy of the vertebra and an aspiration of the psoas abscess, and other diagnostic testing for Mycobacterium tuberculosis were performed. Microbiology or histopathology of infected material confirmed the diagnosis of tuberculosis. Both patients underwent vertebral decompression and internal fixation. In conclusion, the diagnosis of spinal tuberculosis should be considered in patients with vertebral osteomyelitis, psoas abscess, and appropriate risk factors, such as a history of tuberculosis exposure.

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