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POTT’S DISEASE

Definition
Pott’s disease is a presentation of extra pulmonary tuberculosis that affects the spine. It is also called tuberculous spondylitis. The original name was formed after Percival Pott, a London Surgeon. It is most commonly localized in the thoracic region (T9, T10) of the spine.

Causative agent
Mycobacterium tuberculosis

Predisposing factors
• Family history of pulmonary tuberculosis
• Poor environment
• Poor nutrition
• Occupation
• Lack of immunization

Signs and Symptoms
• Back pain
• Fever
• Night sweat
• Anorexia
• Weight loss
• Spinal mass

Diagnostic test
• Increase Erythrocyte Sedimentation Rate- markedly elevated due to inflammation
• Tuberculin skin test (Mantoux test/purified protein derivatives) - this determine whether an individual has been infected with the mycobacterium tuberculosis organism. The test usually consists of an intracutaneous injection of tuberculin, a purified protein derivative of the bacillus.
• Bone biopsy- surgical removal of living body tissue for the study and diagnosis. This is performed to analyze the cause and nature of the disease and on tumors or abnormal tissue growths.
• Radiograph of the spine- to determine the severity or extent of the spinal cord damage.

Medical Management
Chemotherapy
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
Vitamin C, D and B complex

Surgical Management
• Anterior Decompression Spinal Fusion (ADSF)- Best surgical intervention for Pott’s disease.
• Traction and Cast- to immobilize the affected extremities.
• Laminectomy- removal of the ruptured disks in the spine

Nursing Management
• Immobilize the spine
• Provide comfort measures.
• Reposition the patient every 2 hours by the help of other personnel.
• Inspect skin for presence of abscess.
• Increase oral fluid intake
• Encourage the patient to verbalize feelings and concerns.
• Observe for signs of respiratory distress.
• Administer medication as prescribed.