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Suggest Treatment For Pott Disease

Posted on Tue, 9 Aug 2016

Question: My daughter aged 28 yrs is suffering from Potts spine and is under treatment of tuberculosis for last two months but her condition is not improving and she has occasional pain in her back which subsides by using patch and she also also develops severe headache more or less daily.She got married Dec 15.Kindly confirm the line of treatment which is being administered to her or suggest other line of treatment.

Answered by Dr. Dr. Naveen Kumar Sharma (5 hours later)

Brief Answer:
This is not right treatment

Detailed Answer:
Hello, I have studied your case and I think she is not receiving proper treatment. She should receive pyrizinamide also rather then streptomycin which is not used now a days.I would like to know little detail of the illness so that I can offer you better advise.
1.did you have mri of the back, if yes please share the report.
2. Please send me her blood reports and liver function tests reports.
3.is she able to walk or not? Your physician has mentioned paraplegia, is she on the bed? What about her bladder and bowel function?
Please send me answers of these questions. I will try my best to help you. Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Naveen Kumar Sharma (33 hours later)

Hello Sir,all reports are uploaded for your reference.

Answer to Question 3:
As per present condition she is able to walk not with ease due to stiffness on one side but earlier about 2 months back she suffered from paraplegia for which Methyl prednisolone 1gm injection was given at hospital in XXXXXXX
Her Urine & bowl movements are normal.

Please suggest Sir what next to be done
Waiting for ur reply!!!!!!!!!!!!

Answered by Dr. Dr. Naveen Kumar Sharma (10 hours later)

Brief Answer:
She should get a CT guided biopsy

Detailed Answer:
Hello,
I have studied her case. There are two chances that she is not responding to this treatment.
1.It might not be TB
2.It can be MDR TB
In first condition there is chances that it may not be TB. For this she can get CT guided biopsy of the lesion. It will tell us if it is TB or some thing else. It can be some other infection like Brucellosis or malignancy. Biopsy can confirm this.
If it is multi drug resistant TB then also it can cause failure of treatment. So once biopsy is done it should be culture and drug sensitivity should also be checked.
I hope this answer will be useful for you.Let me know if their is any other followup questions.
thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Naveen Kumar Sharma (15 hours later)

Hello Dr. XXXXXXX

Greetings for the day!!!!!!!!!!

Thanks for update we will surely plan to get CT guided biopsy done asap.
As we are residing in XXXXXXX can u please suggest us from where we can get CT guided biopsy done in XXXXXXX also please suggest any specialized center or Doctor for same.

Answered by Dr. Dr. Naveen Kumar Sharma (7 hours later)

Brief Answer:
I would like to suggest you to XXXXXXX spine centre

Detailed Answer:
Hello, I would suggest you to go to XXXXXXX spine centre. It is a good centre and has all the expertise. Dr Chabra will help you.
Thanks

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar