Journal of Preventive Medicine

Disseminated Tuberculosis Masquerading as a Simple Neck Abscess: A Case Report

Background: Pott’s spine with Pre-Vertebral Abscess (PVA) presenting as an anterior neck abscess is a rare clinical entity, which often gets misdiagnosed precluding early diagnosis and treatment.

Case presentation: An Adolescent male who presented with a painless anterior neck swelling which was not responding to routine conservative management. Further investigation of the abscess unveiled a PVA and tubercular degenerative changes of the C6 vertebra. The cervical vertebra (C-spine) changes were initially identified on the Computed Tomographic (CT) scan, which was further confirmed on a Magnetic Resonant Imaging (MRI) of the neck. The PVA secondary to the Pott’s spine had tracked anteriorly to form a painless swelling in front of the neck without any cervical symptoms. The treatment required multidisciplinary teamwork between neurosurgeons, radiologists, pulmonologist, and head and neck surgeons. The patient made a good recovery after initiation of anti-tuberculosis therapy with C-spine stabilization.

Conclusion: Undiagnosed cervical Pott’s spine can lead to fatal consequences due to proximity to neurovascular structures; hence always have a suspicion of C-spine involvement in tubercular neck abscesses. Mutli-disciplinary team involvement is needed in treating patients with Pott’s spine. C-spine stabilization and antitubercular therapy are the main stay of treatment.

Author(s): Benazir Begum and Jayasree Babu*

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