Pott's disease presenting with bilateral psoas abscesses in a resource-poor setting: Case report and literature review
Abstract
Introduction and importance Tuberculosis (TB) primarily affects the lungs, but can cause extrapulmonary TB (EPTB), including spinal TB (Pott's disease), which presents with variable symptoms. Tuberculous psoas abscesses, a complication of Pott's disease, are increasingly reported due to improved diagnostics. Case presentation A 32-year-old male from the Somalia region of Ethiopia presented with a history of chronic lower back pain that had worsened over the preceding month, with lower back swelling, unquantified weight loss, and a slight limp. He also reported intermittent, mild lower quadrant abdominal pain. Physical examination revealed a chronically ill with stable vital sign. A 7 × 5 cm soft tissue swelling, localized to the lumbar area. Due to late presentation and the lack of advanced imaging capabilities such as CT scans at our facility, the diagnostic process was challenging. Spinal swelling was noted, and after incision and drainage, the discharge was analyzed using GeneXpert and Mycobacterium tuberculosis was detected by GeneXpert confirming a diagnosis of spinal tuberculosis, and an abdominal ultrasound showed a psoas abscess. The patient was started on anti-TB therapy and is improving, Case discussion Tuberculous psoas abscess, a known complication of Pott's disease (spinal tuberculosis), is relatively uncommon, occurring in about 5 % of cases despite modern anti-TB treatment. Psoas abscesses can arise primarily or secondarily, the latter resulting from TB spread…
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