Pott's Disease and Cold Abscesses

A 68-year-old-woman was referred to our hospital with persistent back pain and a 7 kg body weight loss over 7 months. She had been undergoing treatment for osteoporosis. She denied productive cough, fever, and night sweats and had no remarkable medical history. Chest radiographs(Figure 1-A and B) showed vertebral collapse and compression fractures from Th8 to Th10, accompanied by a paravertebral mass and tiny nodules in the lungs. Laboratory investigations revealed only mild elevation of ESR; 29 / mm hr. Thoracic computed tomography(CT) (Figure 2-A)demonstrated tiny nodules scattered throughout the lungs. Thereafter, sputum culture was positive for Mycobacterium tuberculosis. Thoracic CT(Figure 2-B)and T2-weighted magnetic resonance imaging(MRI)(Figure 2-C) depicted a 10-cm mass, extending predominantly vertically along the anterior vertebral column(from Th8-Th10). The mass had an enhanced rim, suggesting abscess formation. These images also confirmed the destructive change shown in radiographs at the Th8, Th9, and Th10 levels. We therefore diagnosed tuberculous spondylitis(Pottʼs disease)complicated General Medicine 2012, vol. 13, no. 2, p. 110-112.