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脊柱结核(波特氏病):一例病例报告及临床思考

Spinal Tuberculosis (Pott's Disease): A Case Report and Clinical Considerations.

作者信息

Aung Win Lae Lae, Jibon Noim, Rawashdeh Lama, Raheem Ali, Jaffet Marjorie, Nasim Shahid

机构信息

Medicine, Diana, Princess of Wales Hospital, Grimsby, GBR.

Medicine, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.

出版信息

Cureus. 2024 Nov 18;16(11):e73903. doi: 10.7759/cureus.73903. eCollection 2024 Nov.

DOI:10.7759/cureus.73903
PMID:39697911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11655093/
Abstract

Pott's disease (PD), also known as spinal tuberculosis, accounts for an extremely low percentage of all tuberculosis (TB) cases and typically manifests secondary to an extra-spinal infection through the hematogenous spread. The thoracolumbar vertebrae are the most affected sites in PD, although other spinal regions can also be involved, albeit less frequently. Back pain is the predominant presenting symptom. Systemic symptoms such as fever and weight loss may occur in PD but are more commonly observed in patients with disseminated disease or concurrent extra-spinal TB. This report presents the case of a 26-year-old Asian woman, born outside the United Kingdom, with no significant past medical history or recent travel to TB-endemic areas, who was diagnosed with spinal TB following a series of medical evaluations. MRI of the spine revealed findings highly suggestive of tuberculous spondylitis. She is currently undergoing treatment and showing significant improvement. This case underscores an atypical patient profile for spinal TB, highlighting the necessity for awareness and consideration of this diagnosis even in unusual patient demographics.

摘要

波特氏病(PD),也称为脊柱结核,在所有结核病(TB)病例中所占比例极低,通常继发于脊柱外感染,通过血行播散所致。胸腰椎是波特氏病中最常受累的部位,不过其他脊柱区域也可能受累,只是频率较低。背痛是主要的首发症状。波特氏病患者可能出现发热和体重减轻等全身症状,但在播散性疾病或合并脊柱外结核的患者中更常见。本报告介绍了一名26岁的亚洲女性病例,她出生于英国境外,既往无重大病史,近期也未前往结核病流行地区,在经过一系列医学评估后被诊断为脊柱结核。脊柱磁共振成像(MRI)显示高度提示结核性脊柱炎的表现。她目前正在接受治疗,病情有显著改善。该病例强调了脊柱结核患者的非典型特征,突出了即使在不寻常的患者群体中也需认识和考虑这一诊断的必要性。

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本文引用的文献

1
Pathogenesis, Diagnostic Challenges, and Risk Factors of Pott's Disease.脊椎结核的发病机制、诊断挑战及危险因素
Clin Pract. 2023 Jan 25;13(1):155-165. doi: 10.3390/clinpract13010014.
2
Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements.波特氏脊柱病:诊断成像方式与技术进展
N Am J Med Sci. 2013 Jul;5(7):404-11. doi: 10.4103/1947-2714.115775.
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Spinal tuberculosis: diagnosis and management.脊柱结核:诊断与治疗
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Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'.表现为“压缩性骨折”的脊柱结核(波特氏病)
Spinal Cord. 2002 Nov;40(11):604-8. doi: 10.1038/sj.sc.3101365.
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