The gibbus deformity seen in this case has a broad differential that includes congenital, infectious, traumatic, and neoplastic causes. However, spinal tuberculosis (Pott’s disease) should rise high on the list in a patient with night sweats who is from a tuberculosis (TB)-endemic region. Pott’s disease accounts for approximately half of skeletal TB cases and often affects the lower thoracic and lumbar spine. Diagnosis is confirmed by tissue biopsy with mycobacterial culture and drug susceptibility testing. Multidrug antituberculosis therapy is the mainstay of treatment, with surgery considered for patients with neurologic compromise, spinal instability, or severe kyphosis.
Comment
The gibbus deformity seen in this case has a broad differential that includes congenital, infectious, traumatic, and neoplastic causes. However, spinal tuberculosis (Pott’s disease) should rise high on the list in a patient with night sweats who is from a tuberculosis (TB)-endemic region. Pott’s disease accounts for approximately half of skeletal TB cases and often affects the lower thoracic and lumbar spine. Diagnosis is confirmed by tissue biopsy with mycobacterial culture and drug susceptibility testing. Multidrug antituberculosis therapy is the mainstay of treatment, with surgery considered for patients with neurologic compromise, spinal instability, or severe kyphosis.