Cervical Trauma, A Red Herring To Pott’s Disease: A Case Report.

Abstract

Introduction: Pott’s disease diagnosed following trauma to the spine is a rare occurrence. There were only 13 cases reported to date. We present a case of cervical Pott’s disease diagnosed following trauma. Case presentation: An 18 year old lady with six months history of low-grade fever, drenching night sweats, dull-aching neck pain and progressive weakness of both upper and lower limbs. There was associated weight loss, but no cough. Her symptoms started one month after she was hit with a stick at her neck. Clinical examination revealed a patient with quadriparesis and preserved sensations. Cervical spine MRI showed collapsed C5 vertebra with preserved adjacent discs; hyperintensed lesion compressing the spinal cord anteriorly extending from C3 to C6 levels (Fig. 1). Mantoux test was positive, CRP and ESR were elevated; and sputum Genexpert was negative. She had C5 Anterior Cervical Corpectomy and Fusion. Tissue biopsy showed features of granulomatous infection. She was commenced on anti-TB drugs and has gained full neurologic recovery. Conclusion: History of trauma may be misleading in the evaluation of Pott’s disease. A high index of suspicion is paramount in the identification of this entity.