Pott’s disease in Djbouti Chakib Saad hospital about 80 cases

Abstract

Objective: Describe the epidemiological, clinical, paraclinical, therapeutic and progressive aspects of Pott's disease at the Chakib Saad Hospital (HCS) in Djibouti. Methods: This was a retrospective and descriptive study, which was carried out from January 2014 to September 2017 at the “Chakib Saad Omar” pneumo-phthisiology hospital in Djibouti. It concerned all patients with a medical observation and presenting a clinical and paraclinical picture of spinal tuberculosis or Pott's disease. Results: Out of 6355 cases of tuberculosis recorded, there were 2495 extrapulmonary locations including 80 cases of Potts disease, i.e. 1.25%. The average age of the patients was 48.9 years (with extremes of 15 and 80 years) and the sex ratio was 0.8. The majority (87.4%) of patients had a low socio-economic level. The clinical manifestations were dominated by back pain (96.3%), alteration of the general condition (58.8%), functional impotence (47.5%), paraparesis (36.3%) and fever (27.5%). On imaging, the lumbar and dorsal levels were the most affected (92.5%) with a predilection for the lumbar level in isolation in 43.8% of cases. The XpertMTB /RIF research was carried out in 27 patients (33.75%) with the isolation of BK in 18 extravertebral samples (66.7%) and resistance to rifampicin in 6 patients (6/18; 33%). In 15% of cases, another form of tuberculosis was associated with Pott's disease, especially pleuropulmonary involvement (7.6%). The treatment was exclusively medical in 71 cases (88.8%) and medical-surgical in 9 cases (11.2%). The evolution was marked by healing in 78.8% of cases. Conclusions: Pott's disease still represents a public health problem in Djibouti. Early diagnosis and treatment improve the prognos