UNUSUAL PRESENTATION OF A COLD ABSCESS- CASE REPORT

Tuberculous spondylitis is the most common form of skeletal tuberculosis (TB). This refers to the infection of one or more vertebral bodies by Mycobacterium tuberculosis with or without involvement of the spinal canal. Children with spinal TB commonly present with backpain, spinal tenderness, paraplegia, bony deformities and constitutional symptoms. Here we report a rare case of Pott's spine with large vertebral cold abscess presenting with symptoms of airway compression in a 6 year old boy. The child presented with cough and noisy breathing. Chest x-ray showed mediastinal widening suggestive of lymphadenopathy. CT chest revealed tracheal compression due to prevertebral soft tissue mass. Flexible bronchoscopy confirmed severe compression of entire trachea. MRI spine showed Pott's disease at various levels of vertebrae with massive pre and para vertebral abscess causing tracheal compression. The aspirate of the abscess was positive for mycobacterium tuberculosis. The boy was started on ATT and steroids and he responded very well.