Pott's disease in Abidjan: experience of the department of rheumatology of university teaching hospital of Cocody: about 420 cases.

INTRODUCTION

Pott's disease continues to be rife primarily in ivorian's setting. This large-scale study presents the Ivorian experience in the management of this disease.

AIM

To determine the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of Pott's disease in Abidjan and to identify the factors associated with neurological compressions.

METHODS

Retrospective and analytical study of 420 files of patients suffering from presumptive or confirmed Pott's disease, hospitalized in the rheumatology department of Cocody University Hospital from January 2010 to December 2019.

RESULTS

The hospital frequency of tuberculous spondylodiscitis was 10.2%. Our study population consisted of 223 men and 197 women with an average age of 43.8 ± 15.5 years. A tuberculosis history and a notion of tuberculosis contagion were noted in 4.3% and 13.8% of cases respectively. The mean diagnostic time was 9.67 ± 10.11 months. The main clinical data were spinal syndrome (98.80%) and also tuberculous impregnation signs (84.76%). Neurological complications were noted in 11.66% of cases. Bacilloscopy and PCR BK were positive in 33.71% and 57.14% of cases respectively. Computed tomography was the most requested and performed diagnostic imaging (92.86%). The associated tuberculous targets (11.2%) were visceral (78.70%), in particular pulmonary (75.67%). The mean duration of anti-tuberculosis treatment was 12.42 months with a cure of 97.14% of patients. Diagnostic delay (P = 0.01), gibbosity (P = 0.009), and presence of soft tissue abscesses (P = 0.004) were significantly associated with neurological compressions.

CONCLUSION

Pott's disease is common in Abidjan and affects young adults. It manifests as a spinal syndrome with tuberculous impregnation signs. Computed tomography was the most performed diagnostic imaging. The factors associated with neurological compressions are: diagnostic delay, gibbosity and soft tissue abscesses.