A team led by ISGlobal, an institution supported by “la Caixa”, in collaboration with the Manhiça Health Research Center (CISM), describes a case of spinal tuberculosis in a Mozambican boy. The case, published in The Lancet, highlights the need to identify children that have been in contact with adults with tuberculosis (TB) in order to diagnose and treat them quickly and effectively.
Tuberculosis is the leading infectious killer worldwide (1.5 million deaths in 2018, according to WHO estimates). Almost one quarter of the world population is thought to have a latent TB infection and at risk of developing the disease. The bacterium normally attacks the lungs, but it can also affect other parts of the body, such as the vertebrae. This is known as spinal tuberculosis or Pott’s disease.
Researchers from ISGlobal and CISM describe the case of a boy that was admitted to the Manhiça hospital in Southern Mozambique, with fever, headache, a deformity in the back, a cervical abscess, and paraplegia. His grandmother had recently been diagnosed with TB.
The different tests showed the presence of bacteria in the abscess and lesions of the vertebrae, confirming a diagnosis of disseminated tuberculosis. “This is a very paradigmatic and severe case of Pott’s disease. It is not something easily seen in Europe, but is more frequent in low-income countries with high disease burden,” comments Alberto García-Basteiro, assistant research professor in ISGlobal and coordinator of TB research at CISM.
After the recommended six month-treatment, the patient could walk again but the spine deformity persisted. “This case illustrates the need to diagnose and treat spinal tuberculosis as soon as possible, to avoid catastrophic consequences,” says paediatrician Rosauro Varo, ISGlobal researcher and first author of the study. It also highlights the need to identify children that have been in contact with people with TB, in order to treat them quickly and effectively if necessary.
Varo R, Bila R, Saavedra B, Sitoe A, Uamusse A, Ribó-Aristizabal JL, García-Basteiro AL. Paraplegia and spinal deformity in a Mozambican child with Pott’s disease and tuberculous scrofula. The Lancet. 2019. 394:1691. doi.org/10.1016/S0140-6736(19)32484-5