Case Report: “Spina Ventosa” Tuberculous Dactylitis in a 2 Year Old Boy - A Very Rare Disease

Bandyopadhyay, Ranadeb; Mukherjee, Arindam; Mondal, Rajib

doi:10.2174/1874325001206010118

Cited by 8 publications

(5 citation statements)

References 3 publications

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“…Spina Ventosa occurs in children who have untreated initial pulmonary tuberculosis. 3,4 In this child, the diagnosis was delayed because the initial infection detection in Spina Ventosa was difficult. In our study, the child was diagnosed after a 6-years of symptoms.…”

Section: Discussionmentioning

confidence: 98%

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Late Discovering Spina Ventosa: A Case Report

Ngoc¹,

Thai²,

Van³

et al. 2021

IMCRJ

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Introduction: Spina Ventosa is a rare condition that is easy to misdiagnose as other diseases. We present a case of late-diagnosed Spina Ventosa, which had not only the osteoarticular tuberculosis symptoms but also some severe symptoms, including pleural effusion, ascites, and anemia. By intensive treatment, our patient recovered completely. Case Report: A 7-year-old boy was admitted with complaints of painless swelling of metacarpals, metatarsals, and phalanges of his hands and feet and a discharging sinus of the left toe. There was no family or past history of tuberculosis. His immunizations were up to date. General examination revealed that the child had pallor and was emaciated. No lymphadenopathy was detected. Investigations revealed hemoglobin: 74 g/l, and erythrocyte sedimentation rate (ESR) was 42 mm/hour. QuantiFERON-TB test was positive. The radiograph showed irregular swelling with sclerosis of the underlying bones. The right-hand x-ray showed cortical destruction, sclerosis, and cystic expansion or right second metacarpal. Chest x-ray indicated pleural effusion. Histopathological examination of specimen from the foot and lung and abdomen fluid confirmed tuberculosis. The child was treated with the first-line tuberculosis treatment regimen (Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide) for two months, followed by Isoniazid, Rifampicin, and Pyrazinamide for a further four months. His lesions disappeared after six weeks of intensive treatment. Conclusion:A delay in diagnosis and treatment of tuberculosis can lead to systemic manifestations in multiple organs. Despite the delay in diagnosis, this child had a good outcome due to being treated promptly and adequately after the presentation.

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Section: Discussionmentioning

confidence: 98%

“…During the initial infection, untreated pulmonary tuberculosis spreads to the skeletal system through the lymphohematogenous route. 3 Spina Ventosa often occurs in 1–5% of children who have untreated initial pulmonary tuberculosis. 4 , 6 Tubercular dactylitis rarely occurs without an initial infection.…”

Section: Discussionmentioning

confidence: 99%

Late Discovering Spina Ventosa: A Case Report

Ngoc¹,

Thai²,

Van³

et al. 2021

IMCRJ

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“…[13] There is recent published report of diagnostic dilemma and radical excision of such lesion as tumor in a young 2-year-old child. [14] Presence of draining sinus in the tuberculous osteomyelitis may hinder its distinction from pyogenic disease. Clinically, pyogenic osteomyelitis tends to be acutely painful, swollen, and hot with fever.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis

2013

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Tuberculous dactylitis is a distinctly uncommon, yet well recognized form of tuberculosis involving the small bones of the hand or foot. It occurs in young children in endemic areas under 5 years of age. Tuberculosis of the short tubular bones like phalanges, metacarpals or metatarsals is quite uncommon beyond 6 years of age, once the epiphyseal centers are well established. The radiographic features of cystic expansion have led to the name “Spina Ventosa” for tuberculous dactylitis of the short bones. Scrofuloderma is a mycobacterial infection affecting children and young adults, representing direct extension of tuberculosis into the skin from underlying structures e.g. lymph nodes. An 8-year-old malnourished girl had multiple axillary ulcers with lymphadenopathy. Tuberculous dactylitis with ipsilateral axillary scrofuloderma was suspected on clinical and radiological grounds. The suspicion was confirmed by histology and bacteriology. The patient responded to antitubercular drugs with progressive healing of the lesions without surgery. Concomitant presence of these dual lesions suggesting active disseminated tuberculosis in immune-competent child over 6 years is very rare and hardly reported.

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“…The absence of periosteal reaction characterises TB osteitis. 7 MRI of the affected finger shows tenosynovitis, synovitis, marrow oedema and osteolytic lesions. It may also show the typical finding of caseous necrosis on contrast study.…”

Section: Dactylistis and Tuberculosismentioning

confidence: 99%

Isolated Index Finger Dactylitis with Hilar Adenopathy

Ojha¹,

Patro²,

Vaidya³

et al. 2022

The Indian Journal of Chest Diseases and Allied Sciences

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Dactylitis due to tuberculosis (TB) is an extremely uncommon manifestation of TB. We report a unique case of isolated index finger dactylitis with right hilar adenopathy due to TB in a 15-year-old immunocompetent student. High index of clinical suspicion, radiological findings and histological confirmation helped in the diagnosis. Anti-tuberculous therapy remains the cornerstone for the management of these cases.

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Case Report: “Spina Ventosa” Tuberculous Dactylitis in a 2 Year Old Boy - A Very Rare Disease

Cited by 8 publications

References 3 publications

Late Discovering Spina Ventosa: A Case Report

Late Discovering Spina Ventosa: A Case Report

Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis

Isolated Index Finger Dactylitis with Hilar Adenopathy

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