[Sacral bone tuberculosis in a 6 year-old child].

Abstract

BACKGROUND:

Spinal tuberculosis is now rare in developed countries; its appearance in sacral vertebrae is exceptional.

CASE REPORT:

A 6 year-old boy was admitted because he had suffered from lumbar pain and rigidity for 24 hours, limiting anterior flexion. X-rays of the spine was normal, but a CT-scan showed lytic lesions of the sacrum. Bone scintigraphy showed no inflammatory lesions. Ewing sarcoma was diagnosed: surgical biopsy showed a cold abscess containing many bacilli that where resistant to decoloration with acid-alcohol. They were cultured for 12 days and identified as Mycobacterium tuberculosis. The boy had been given a BCG vaccination at the age of 2 years and was not immunodeficient. He was treated with isoniazid, rifampin and pyrazinamide for 2 months followed by isoniazid plus rifampin for 1 year. A cold abscess in the presacral area rupturing into the sacro-iliac articulation pointed above the left iliac wing during treatment and was treated by surgical debridement. Eighteen months later, the boy is well but still avoids bending.

CONCLUSION:

A sacrally located bone tuberculosis is difficult to diagnose. Careful therapy is necessary to avoid sequelae that may lead to spinal curvature.

• Authors: F Raymond, G Levard, B Bataille
• Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 1 Issue 5 Pg. 489-92 (May 1994) ISSN: 0929-693X [Print] France
• Vernacular Title: Tuberculose osseuse sacrée chez un enfant de 6 ans.
• PMID: 7951834 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Child
• Humans
• Male
• Sacrum
• Tomography Scanners, X-Ray Computed
• Tuberculosis, Spinal (diagnosis, therapy)