Abstract

Title: Skeletal Tuberculosis

Introduction: Skeletal tuberculosis (TB) refers to TB involvement
of the bones and/or joints commonly cause by microorganism
Mycobacterium Tuberculosis. In this case a Filipino female with a
pulmonary tuberculosis developed a skeletal tuberculosis in the right hip.
This case is remarkable because skeletal disease in female adolescent is
uncommon. Furthermore, The Philippines has the seventh highest TB
burden among all countries in the world as of 2007. Skeletal Tuberculosis
accounts for 10 to 35 percent of cases of extrapulmonary tuberculosis in
the world and, overall, for almost 2 percent of all TB cases. Reported rates
of extrapulmonary TB are higher among immigrants from endemic areas to
developed countries; this may be due in part to immigration screening
procedures for pulmonary TB. One retrospective review of skeletal TB
between 1980 and 1994 in France noted 103 cases of spinal TB; 68
percent of patients were foreign-born, the majority from Africa.
Case Description: A 14 year-old Filipino female with a medical history
significant for Right Hip pain secondary to Skeletal Tuberculosis presented
to the hospital with complaint of fever and limitation of movement. She
reported to have a diagnosis of PTB (2014) and currently on treatment.
Physical examinations reveals conscious coherent not in respiratory
distress, warm moist skin, anicteric sclera, pink palpebral and no
nasolacrimal discharge, moist bucal mucosa, no murmurs heard, flat
abdomen, no tympanic tenderness. Laboratory reveals low hemoglobin,
hematocrit, mean corpuscular volume levels and elevated eosinophils
count. CXR reveals PTB of both upper lobes. She was admitted for surgical
debridement of right hip and thigh and also a diagnosis of Potts disease of
Right hip and thigh was made. Medical management consist of IVF of D5
0.3 NaCl 1L and Fixcom forte 4 tabs and Multivitamis 1 capsule. On the
day 6 of her treatment surgical management consist of debridement of right
hip and thigh and day 7 had an application of bucks traction. The patient
had been discharge on the day nine.

Discussion: The case illustrates the potential benefit of surgical
debridement as part of the management of patient presenting skeletal
tuberculosis. This form of treatment can removed pus, necrotic tissue, and
dead cartilage hence decreasing the progression of the disease. Research
on this topic is recommended.