Isolated tuberculosis of sacrum with monoparesis: an atypical presentation

A case report of percutaneous endoscopic debridement for treating lumbar tuberculous spondylitis with large psoas abscess

Introduction and importance

Case presentation

Discussion

Conclusion

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Early diagnosis and management of spondylitis tuberculosis have special importance in preventing complications

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We reviewed the evaluation of clinical outcome, laboratory findings, and radiological post-minimal invasive endoscopic debridement in spinal tuberculosis with psoas abscess

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Post percutaneous endoscopic debridement, patients had a good response in eradicating germs with clinical, laboratory, and radiology findings improvement with resorption of psoas abscess

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This study is concerned that a combination of the administration of anti-tuberculous drugs and surgical treatment is the best choice for patients with spondylitis tuberculous with large psoas abscess

Submuscular gluteal abcess: An unusual presentation of rare sacral tuberculosis

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Gluteal abscess and sacral tuberculosis are rare entities in spine tuberculosis, as to our knowledge; this is the second case report about it.

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MRI has a great role to describe anatomical pathophysiology of the abscess dissemination from sacral tuberculosis.

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Sacral tuberculosis should be made as the main differential diagnosis for atypical sacral lesion that occurs with submuscular gluteal abscess.

Introduction

Both gluteal abscess and sacral tuberculosis are rare entities in spinal tuberculosis cases. Even in endemic country, this atypical presentation may be the cause of delayed diagnosis and treatment.

Presentation of case

A 51-year-old woman was admitted with painless massive lump on both of her thighs that have been enlarging for the past 6 months. She had a history of previous tuberculosis treatment. From the MRI examination submuscular gluteal abscess, which was an extension of the sacral tuberculosis, were found. Open debridement and biopsy were performed, which confirmed the suspicion of tuberculosis. Oral anti tuberculosis drugs were administered after. There was no recurrence and complication at the final follow up.

Discussion

Cold abscess formation is common in spine tuberculosis however the formation of gluteal abscess as the extension of sacral tuberculosis is rare. Although MRI's specificity in determining the underlying cause is poor, it has a great role not only determining the location and size of the lesion, but also to describe anatomical pathophysiology of the abscess dissemination from sacral tuberculosis.

Conclusion

Despite the limitation of the study and the rarity of this case, tuberculosis should be made as the main differential diagnosis for atypical sacral lesion that occurs with submuscular gluteal abscess.