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

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 Mycobacterium tuberculosis 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.