WHEN RECURRENT CERVICOCEPHALIC PAIN SHOULD NOT BE UNDERESTIMATED AND HOW TO AVOID MISDIAGNOSIS: A CASE REPORT OF CERVICAL POTT DISEASE.
Authors:
Affiliation:
1 Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
2 Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
Doi: 10.54936/haoms242p63
ABSTRACT:
Abstract: Background: Isolated involvement of upper cervical and craniovertebral junction is an extremely rare location of tuberculosis infection, but might lead to severe consequences if the diagnosis is delayed or misread.
Case presentation: The authors present a case of cranio-vertebral junction tuberculosis with atlantoaxial and epistropheus erosion in a 28-year-old Indian man who came to the emergency department several times for a worsening neck pain that had been present for about 8 months, and mild dysphagia. A skull-thorax-upper-lower-abdomen CT scan and a cervical-dorsal MRI were performed, showing erosive phenomena of the left lateral portion of the atlas and of the odontoid process of the axis of a probably infectious origin. An intraoral biopsy of the posterior pharyngeal wall of the was performed without external approaches or aid of endoscopic instrumentation to the affected site.
Conclusions: Both the biopsy and several microbiological samples showed a mycobacterium tuberculosis complex infection. The patient underwent a quadruple anti-TB treatment. Further treatment options are discussed.
KEY WORDS: intraoral biopsy, tuberculosis, mycobacterium tuberculosis; cervical infections, Pott’s desease, Pott’s spine.
Authors:
Affiliation:
1 Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Rome, Italy
2 Oncological and Reconstructive Maxillo-Facial Surgery Unit, Policlinico Umberto I, Viale del Policlinico 155, 00161 Rome, Italy
Doi: 10.54936/haoms242p63
ABSTRACT:
Abstract: Background: Isolated involvement of upper cervical and craniovertebral junction is an extremely rare location of tuberculosis infection, but might lead to severe consequences if the diagnosis is delayed or misread.
Case presentation: The authors present a case of cranio-vertebral junction tuberculosis with atlantoaxial and epistropheus erosion in a 28-year-old Indian man who came to the emergency department several times for a worsening neck pain that had been present for about 8 months, and mild dysphagia. A skull-thorax-upper-lower-abdomen CT scan and a cervical-dorsal MRI were performed, showing erosive phenomena of the left lateral portion of the atlas and of the odontoid process of the axis of a probably infectious origin. An intraoral biopsy of the posterior pharyngeal wall of the was performed without external approaches or aid of endoscopic instrumentation to the affected site.
Conclusions: Both the biopsy and several microbiological samples showed a mycobacterium tuberculosis complex infection. The patient underwent a quadruple anti-TB treatment. Further treatment options are discussed.
KEY WORDS: intraoral biopsy, tuberculosis, mycobacterium tuberculosis; cervical infections, Pott’s desease, Pott’s spine.