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Cuneyt Ensari, Arzu Ensari, Giyas Ayberk, Murat Suher, Eyup Koc
CaseRepClinPractRev 2005; 6:157-160
Background: The diagnosis of spinal tuberculosis (Pott’s disease) in uremic patients may be difficult and without high index of suspicion delay in diagnosis is common.Case Report: We present here, unusual features of Pott’s disease in two hemodialysis patients. The first patient presented with cervical spinal involvement and a concomitant pyogenic infection in the same location. The second patient presented with lumbar spinal involvement affecting only the posterior vertebral elements characterized by destruction of the vertebral arch. Both patients were operated and multidrug antituberculosis therapy was given for 1 year without any side effects or toxicity. Partial improvement was achieved in the first patient while the second patient recovered completely. Conclusions: Clinicians dealing with uremic patients should be aware of unusual manifestations of tuberculosis in order to establish early diagnosis and initiate intensive appropriate treatment. The cases presented here emphasize that, where available, magnetic resonance imaging is ideal to evaluate spinal structures and that early decompressive surgery plus antituberculosis chemotherapy seem to remain the preferred mode of therapy for Pott’s disease.