Pott's disease in heroin addicts.

Five cases of tuberculous vertebral osteomyelitis occurred in heroin addicts at St Luke's Hospital Center between 1955 and 1975. All patients were men, and four were between 19 and 33 years of age. In contrast with the indolent onset typical to pyogenic or fungal vertebral osteomyelitis in heroin addicts, patients with Pott's disease had an acute toxic reaction, with fever, back pain, weight loss, and night sweats. Neurologic abnormalities, uncommon with pyogenic or fungal vertebral infection, occurred in all patients with tuberculous involvement of the spine. Roentgenograms of the spine were atypical in four patients, including two with an "ivory vertebra." All patients had involvement of extravertebral sites, and one patient had infection with Mycobacterium tuberculosis and M avium.