Ziekte van Pott: zeldzaam, maar niet uitgestorven

Pott’s disease: rare but not extinct In a 78-year-old woman with a history of colon diverticulitis, an incidental finding of spondylodiscitis T12-L2 was found on the CT scan to evaluate the diverticulitis. The finding was confirmed on an MRI, showing multifocal involvement of T12-L2 and the intervertebral discs with alongside an intraspinal abscess collection and a psoas abscess. Further investigations (hemocultures and cultures of the abscess) remained negative. Empirical antibiotic therapy was initiated with intravenous ceftriaxone and metronidazole for 6 weeks. The patient was discharged after the antibiotic treatment. One week later, the patient presented at the emergency department due to abnormal liver function values. Because of the multifocal lytic lesions, she received a pedicle screw fixation T11-L2 with a biopsy of L2 at the same time. The biopsy sample showed a positive PCR for Mycobacterium tuberculosis. The patient was diagnosed with tuberculous spondylitis. Multidrug anti-tubercular therapy was initiated with a 4-drug regimen (rifampicine, isoniazide, ethambutol and pyrazinamide).