Archives de pediatrie : organe officiel de la Societe francaise de pediatrie · 1994
[Sacral bone tuberculosis in a 6 year-old child].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Raymond F, Levard G, Bataille B
Аннотация
BACKGROUND: Spinal tuberculosis is now rare in developed countries; its appearance in sacral vertebrae is exceptional.
CASE REPORT: A 6 year-old boy was admitted because he had suffered from lumbar pain and rigidity for 24 hours, limiting anterior flexion. X-rays of the spine was normal, but a CT-scan showed lytic lesions of the sacrum. Bone scintigraphy showed no inflammatory lesions. Ewing sarcoma was diagnosed: surgical biopsy showed a cold abscess containing many bacilli that where resistant to decoloration with acid-alcohol. They were cultured for 12 days and identified as Mycobacterium tuberculosis. The boy had been given a BCG vaccination at the age of 2 years and was not immunodeficient. He was treated with isoniazid, rifampin and pyrazinamide for 2 months followed by isoniazid plus rifampin for 1 year. A cold abscess in the presacral area rupturing into the sacro-iliac articulation pointed above the left iliac wing during treatment and was treated by surgical debridement. Eighteen months later, the boy is well but still avoids bending.
CONCLUSION: A sacrally located bone tuberculosis is difficult to diagnose. Careful therapy is necessary to avoid sequelae that may lead to spinal curvature.
CASE REPORT: A 6 year-old boy was admitted because he had suffered from lumbar pain and rigidity for 24 hours, limiting anterior flexion. X-rays of the spine was normal, but a CT-scan showed lytic lesions of the sacrum. Bone scintigraphy showed no inflammatory lesions. Ewing sarcoma was diagnosed: surgical biopsy showed a cold abscess containing many bacilli that where resistant to decoloration with acid-alcohol. They were cultured for 12 days and identified as Mycobacterium tuberculosis. The boy had been given a BCG vaccination at the age of 2 years and was not immunodeficient. He was treated with isoniazid, rifampin and pyrazinamide for 2 months followed by isoniazid plus rifampin for 1 year. A cold abscess in the presacral area rupturing into the sacro-iliac articulation pointed above the left iliac wing during treatment and was treated by surgical debridement. Eighteen months later, the boy is well but still avoids bending.
CONCLUSION: A sacrally located bone tuberculosis is difficult to diagnose. Careful therapy is necessary to avoid sequelae that may lead to spinal curvature.