Two cases of Pott disease associated with bilateral psoas abscesses - Case report

Study Design. Two case reports and a literature review of spinal osteomyelitis with bilateral psoas abscesses secondary to Mycobacterium tuberculosis. Objective. Describe the presentation, diagnosis, treatment, and outcome of spinal tuberculosis (i.e., Pott disease). Summary of Background Data. Pott disease is a well-known condition in unindustrialized countries causing multiple spinal deformities in children. However, its association with bilateral psoas abscesses in adults with minimal risk factors is not commonly recognized in industrialized countries. Methods. There are 2 adult cases of Pott disease with psoas abscesses presented, and the relevant literature is reviewed. Plain spine radiographs, spine magnetic resonance imaging ( MRI), routine bacterial and acid-fast bacilli cultures of infected material, and other diagnostic testing for M. tuberculosis were performed. Results. Plain radiographs and MRI of the spine showed vertebral osteomyelitis with compression fractures, and MRI also revealed bilateral psoas abscesses. Acid-fast bacilli culture and other M. tuberculosis diagnostic testing of psoas abscess specimens confirmed the diagnosis of M. tuberculosis. Conclusion. Although spinal osteomyelitis with psoas abscess is classically associated with Staphylococcus aureus infection, Pott disease should be considered in this clinical setting, and risk factor assessment and testing for tuberculosis should be performed.