Okuyama Y, Nakaoka Y, Kimoto K, Ozasa K
Department of Preventive Medicine, Kyoto Prefectural University of Medicine.
Intern Med. 1996 Nov;35(11):883-5. doi: 10.2169/internalmedicine.35.883.
We report a case of tuberculous spondylitis (Pott's disease) with bilateral pleural effusion in a 25-year-old male patient. Left-pleural effusion was observed on admission. The initial diagnosis was tuberculous pleuritis. However, during anti-tuberculosis chemotherapy, back pain and right-pleural effusion appeared. by further examination, we diagnosed an active tuberculous spondylitis of the 11th and 12th thoracic vertebrae possibly by the dissemination of Mycobacterium tuberculosis through blood circulation or lymphatic circulation. In cases in which anti-tuberculosis chemotherapy is not so effective, the possibility of the rarely-appearing extra-pulmonary manifestation of tuberculous spondylitis must be considered.
我们报告一例25岁男性患者的结核性脊柱炎(波特氏病)伴双侧胸腔积液。入院时发现左侧胸腔积液。初步诊断为结核性胸膜炎。然而,在抗结核化疗期间,出现了背痛和右侧胸腔积液。通过进一步检查,我们诊断为第11和12胸椎的活动性结核性脊柱炎,可能是结核分枝杆菌通过血液循环或淋巴循环播散所致。在抗结核化疗效果不佳的病例中,必须考虑罕见的结核性脊柱炎肺外表现的可能性。