Sacrum Pott’s disease: A rare location of spine tuberculosis

Abstract

Spinal tuberculosis is a common form of musculoskeletal tuberculosis. However, a tubercular involvement of the sacrum is very rare. The aim of this case report is to describe a rare case of tuberculosis of the sacrum. A 37-year-old man was referred to the Rheumatology department of the regional teaching hospital of Lomé, Togo for a 9 month history of low-grade fever, pain and swelling of the sacral region. X-ray and computerized tomography (CT) scan of the sacrum revealed an osteolytic lesion. Cold abscess aspiration cytology was negative for acid-fast bacilli but Polymerase Chain Reaction (PCR) using the Xpert MTB/RIF (Mycobacterium tuberculosis/resistance to rifampicin) diagnostic test was positive in revealing M. tuberculosis. The evolution under specific antibiotic treatment has been favorable, with the disappearance of sacral pain and a weight recovery of 20 kg in 12 months. Isolated sacral tuberculosis is rare but a high degree of suspicion is needed in the presence of atypical clinical and radiological features of a sacral lesion particularly in Black Africa.