Tuberculous spondylitis with large prevertebral abscess

Case contributed by Dr Andrew Dixon

Presentation

29 year old male migrant to Australia from India who presented to Emergency with Horner's Syndrome. On examination he was found to have large swelling in the neck.

Patient Data

Age: 29 years
Gender: Male

Chest radiographs show widened superior mediastinum with trachea displaced anteriorly on the lateral image. Prevertebral soft-tissues are expanded: greater than one vertebral body thickness in the lower cervical spine.

CT and MR imaging shows large septated prevertebral / paravertebral cervical and upper thoracic low density collection with enhancing wall. Destruction of multiple upper thoracic vertebrae is seen along with an epidural collection.  

MR imaging shows large septated prevertebral / paravertebral cervical and upper thoracic low intensity collection with enhancing wall. Destruction and abnormal enhancement of multiple upper thoracic vertebrae is seen along with an epidural phlegmon. 

Case Discussion

CXR shows widened superior mediastinum with the trachea displaced anteriorly on the lateral image. Prevertebral soft-tissues are expanded: greater than one vertebral body thickness in the lower cervical spine.

CT and MR imaging shows a large septated prevertebral / paravertebral cervical and upper thoracic low density collection with enhancing wall. Destruction of multiple upper thoracic vertebrae is seen along with an epidural collection.  

Features are consistent with tuberculous spondylitis (Pott's Disease) complicated by a large prevertebral / paravertebral abscess. Acid-fast-bacilli were subsequently confirmed. 

PlayAdd to Share

Case information

rID: 9354
Case created: 8th Apr 2010
Last edited: 10th May 2017
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.