A Case Report of a Tragic Story of Pott's paraplegia Cured after Four Years

Pott's disease is a form of spondylodiscitis caused by mycobacterium tuberculosis. It is a serious form of spinal infections that can lead to terrible disabilities in case of undiagnosed and treated early. To document a case of Pott's paraplegia cured after four years. This report details the case of a patient with an undiagnosed case of spinal tuberculosis in a 55-year-old man who had complained of lower back pain and tenderness over the course of several months. The case progressed to the point that he had difficulty standing and numbness, then weakness, of the lower limbs. This patient was only treated with analgesics and antibiotics. Herbal remedies, massage and amulets also played a major role in his treatment. The patient remained bed-bound and paraplegic for four years, after which, he was referred for a thoracolumbar Magnetic Resonance Imaging (MRI) and was diagnosed with tuberculous spondylodiscitis. The patient underwent decompression surgery and started anti-tuberculous drugs. He regained his ability to walk. His lifestyle has improved and he has been living independently for eight years. In conclusion, diagnosis and correct treatment can result in a patient who was previously handicapped becoming independent once again. Medical imaging using MRI can play an essential role in the diagnosis of spinal lesions, including those present in cases of Pott's disease.

Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses

BACKGROUND &OBJECTIVE

Chronic rhino sinusitis (CRS) is an inflammatory condition of the paranasal sinuses and the nasal passage lasting more than three months either with or without sinonasal polyps. This study aimed to report the common sinonasal lesions associated with CRS according to the histopathology results, to compare between clinical and histopathological diagnoses, and to compare between radiological and histopathological diagnoses of the sinonasal lesions.

METHODS

A retrospective study of the electronic records of 82 patients diagnosed with CRS with nasal polyps. All patients underwent endoscopic sinus surgery and histopathological examination of surgical biopsies. The collected data were analyzed using SPSS program. Coparison between clinical and histopathological diagnoses was done. This study was conducted at Alsafwa Consultative Medical center (ACMC) in Almukalla city, Hadhramout province in Republic of Yemen.

RESULTS

Out of 82 patients, the ages ranged from 4 to 90 years (mean: 34.48±17.74 years), and 54.88% were females. Inflammatory polyps were the most common lesion (31.4%), then allergic polyps (30.5%). Nasopharyngeal carcinoma (NPC) was reported in 9.8% of the lesions and all were unilateral. The results revealed strong compatibility between clinical and histopathological diagnoses (p<0.001, kappa= 0.215), and significant compatibility between radiological and histopathology diagnoses (p=0.007).

CONCLUSION

Inflammatory and allergic polyps are the most common benign bilateral lesions associated with chronic rhinosinusitis, which can be correctly diagnosed clinically in most cases. Unilateral nasal polyps have high rates of malignancies and should be check carefully by endoscopy and histopathology. Computed tomography has some pitfalls in diagnosing of fungal sinusitis.