Torticollis as a sign of spinal tuberculosis

Boussetta, Rim; Zaidi, Mohamed; Sami, Sami Bouchoucha; Lafrem, Rafik; Msakeni, Ahmed; Saied, W.; Nessib, Nebil

doi:10.11604/pamj.2020.36.277.22977

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…tortikolis a febrilie u dvanáctileté dívky s TB krční páteře. (19) Pro verifikaci suspektního postižení OATB můžeme použít rentgenové zobrazení, CT nebo magnetickou rezonanci. I vzhledem k senzitivitě je metodou volby zobrazení páteře v celém rozsahu pomocí magnetické rezonance.…”

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Tuberculous spondylitis or Pott's disease - a relic of the past?

Bača¹,

Magner²,

Martinů³

et al. 2023

Ces-slov Pediat

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Klinika pediatrie a dědičných poruch metabolismu, 1. LF UK a VFN, Praha ³ Pediatrická klinika, 2. LF UK a FN Motol, Praha souhrn Bača Ľ, Magner M, Martinů V, Doležalová k. tuberkulózní spondylitida neboli Pottova nemoc -relikt minulosti? Tuberkulóza (TB) je onemocnění způsobené skupinou bakterií označovanou jako M. tuberculosis complex. Tuberkulóza u dětí postihuje nejčastěji plíce (až v 80 % případů), může však postihnout i další orgány (mimoplicní forma tuberkulózy). Česká republika představuje zemi s nízkou incidencí tuberkulózy (méně než 5 případů na 100 000 obyvatel), (1) i přesto se u nás vyskytují vzácné a závažné formy plicní i mimoplicní. Představujeme kazuistiku roční dívky s plicní a kombinovanou mimoplicní formou tuberkulózy (konkrétně postižení páteře a mozku). Pacientka byla pro přetrvávání zastínění na skiagramu hrudníku podrobena dalšímu vyšetřovacímu procesu, který potvrdil diagnózu plicní tuberkulózy. Překvapivým vedlejším nálezem byla hrudní spondylitida s abscesem a nález tuberkulomů v CNS. Antituberkulózní léčbou, spondylochirurgickou operací a multioborovou spoluprací bylo dosaženo zlepšení klinického stavu. klíčová slova: tuberkulóza, mimoplicní tuberkulóza, osteoartikulární tuberkulóza, Pottova nemoc, bazilární meningitida, tuberkulom suMMary Bača Ľ, Magner M, Martinů V, Doležalová k. tuberculous spondylitis or Pott's disease -a relic of the past?Tuberculosis (TB) is a disease caused by a group of bacteria, collectively named the M. tuberculosis complex. In most cases, tuberculosis in children affects the lungs (80%) but can affect any other organ (extrapulmonary tuberculosis). Although the Czech Republic is a country with a low incidence of tuberculosis (< 5 cases per 100 000 population per year), (1) severe and rare forms of extrapulmonary tuberculosis occur. This case report presents a one-year-old girl with coincident pulmonary and two extrapulmonary forms of tuberculosis (spine and brain). The patient due to persistent X-ray opacification underwent other diagnostic examinations verifying lung tuberculosis. The surprising finding was thoracic spondylitis with abscess and tuberculomas in the CNS. We achieved good clinical progresswith antituberculosis treatment, spine surgery intervention, and a multidisciplinary approach.

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Section: Diskuseunclassified

Tuberculous spondylitis or Pott's disease - a relic of the past?

Bača¹,

Magner²,

Martinů³

et al. 2023

Ces-slov Pediat

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“…In a recent systematic review of 45 articles, 37 out of the 95 included patients (39%) had torticollis as the first and only presenting symptom of a brain tumor [6]. Numerous case reports in the literature describe other unusual causes of pediatric torticollis [3,[7][8][9][10][11][12][13][14][15][16]. Because of these conflicting and sparse data, a very recent review [17] and best practice guideline [18] suggest that there is still ample room for research.…”

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confidence: 99%

Pediatric torticollis: clinical report and predictors of urgency of 1409 cases

Raucci,

Roversi,

Ferretti

et al. 2024

Ital J Pediatr

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Background To date, the etiology and risk factors of torticollis are still poorly defined in the pediatric literature. Especially in the Emergency Department (ED) scenario, it is critical to reliably distinguish benign and transient conditions from (potentially) life-threatening disorders. This study describes the clinical characteristics of a large sample of children with torticollis. The aim of our study was to detect epidemiology, etiology and predictive variables associated with a higher risk of life-threatening conditions in acute torticollis. Methods We conducted a pediatric retrospective study of acute torticollis over a 13-year period referred to the ED of a tertiary pediatric Hospital. We reported the characteristics in the overall sample and in two subgroups divided according to urgency of the underlying condition. Furthermore, we developed a multivariate model aimed at identifying the main clinical predictors of the need for urgent care. Results 1409 patients were analyzed (median age 5.7 years, IQR 5.8). A history of trauma was present in 393 patients (27.9%). The symptom most frequently associated with torticollis were pain (83.5%). At least one pathological finding was found in 5.4 to 7.9% of patients undergoing further imaging. Hospitalization was required in 11.1% of cases (median duration 4 days). The most frequent etiologies of torticollis were postural cause (43.1%), traumatic (29.5%), and infective/inflammatory (19.1%). A longer time from onset of torticollis and the presence of headache or vomiting were strongly correlated with an underlying urgent condition, after adjusting for the other clinically and statistically significant variables in the bivariate analysis. Conclusion Our study shows that an urgent condition most commonly occur in patients presenting with history of trauma or headache, vomiting and torticollis for more than 24 h should undergo further diagnostic evaluation and short-term follow-up, restricting invasive or expensive investigations to patients with clinical suspicion of an underlying harmful condition.

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