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[布基纳法索一名免疫功能正常、颈部定位的患者中与波特病相关的多发性结核性冷脓肿]

[Multiple tuberculous cold abscesses associated with Pott's disease in an immunocompetent patient with cervical localization in Burkina Faso].

作者信息

Bargo Cheick Rachid, Sare Wendbénédo Habacuc, Kaba Mohamed Karfalla, Nana Modibo Abdoulaye

机构信息

Service d'ORL et de chirurgie cervico-faciale du Centre hospitalier universitaire Bogodogo, Ouagadougou, Burkina Faso.

Unité d'ORL et de chirurgie cervico-faciale du Centre hospitalier universitaire Tengandogo, Ouagadougou, Burkina Faso.

出版信息

Med Trop Sante Int. 2025 Jan 6;5(1). doi: 10.48327/mtsi.v5i1.2025.600. eCollection 2025 Mar 31.

Abstract

INTRODUCTION

Cervical Pott's disease is a very rare localization of bone tuberculosis. Its association with cercico-thoracic cold abscesses is also exceptional.

OBSERVATION

A 36-year-old black African patient of Burkinabè origin, with a history of tuberculosis infection (his mother had pulmonary tuberculosis) and no other pathological history, presented with chronic inflammatory cervicalgia that had been developing for six months in a non-febrile context of altered general condition. Examination showed a left latero-cervical swelling associated with a left basithoracic swelling, both fluctuant. Pleuropulmonary and neurological examinations were normal. HIV serology and tuberculin skin test were negative. Cervico-thoracic computed tomography revealed multiple abscesses. The abscesses were incised and drained. Analysis of the specimen showed the presence of acid-fast bacilli by direct examination and by Xpert test, with sensitivity to rifampicine. The diagnosis was multiple tuberculous cold abscesses associated with cervical Pott's sore. The patient was started on standard analgesics and antituberculosis drugs for 12 months. The course was favorable, with a follow-up of one year after treatment.

CONCLUSION

Cold cervical abscess complicating Pott's disease is exceptional. Imaging and the geneXpert assay are now rapid and effective diagnostic tools for tuberculosis. This particular form should always be suspected in endemic areas.

摘要

引言

颈椎结核是骨结核一种非常罕见的发病部位。其合并颈胸寒性脓肿的情况也很罕见。

病例

一名36岁的来自布基纳法索的非洲黑人患者,有结核感染病史(其母亲患有肺结核)且无其他病史,在全身状况改变但无发热的情况下,出现了持续6个月的慢性炎性颈部疼痛。检查发现左侧颈侧肿胀,并伴有左侧胸廓底部肿胀,二者均有波动感。胸膜肺部和神经系统检查均正常。艾滋病毒血清学检查和结核菌素皮肤试验均为阴性。颈胸计算机断层扫描显示有多个脓肿。对脓肿进行了切开引流。标本分析通过直接检查和Xpert检测显示存在抗酸杆菌,对利福平敏感。诊断为与颈椎结核性溃疡相关的多发性结核寒性脓肿。患者开始使用标准镇痛药和抗结核药物治疗12个月。病程顺利,治疗后随访一年。

结论

颈椎结核合并寒性脓肿的情况很罕见。影像学检查和基因Xpert检测现在是诊断结核病快速有效的工具。在流行地区应始终怀疑这种特殊形式的疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ce3/12001987/eb2923950c42/mtsi-05-5679-g001.jpg

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