Report Devera

7/29/2019 Report Devera

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POTT’S

DISEASE



Other name:

• Extrapulmonary Tuberculosis• Tuberculosis of the Spine

• Tuberculous Spondylitis

• Pott’s Caries

• David’s Disease

• Pott’s Curvature



Pott’s disease is a presentation of

extrapulmonary tuberculosis that affects the

spine.

a kind of tuberculous arthritis of the

intervertebral joints.

Pott's disease is tuberculosis of the spinal

column.

Pott's disease is named after Percival Pott (1714-

1788), who was a surgeon in London.



Causative organism:Mycobacterium

tuberculosis.

Spread: Haematogenous.

(by blood)



Risk factors

• Modifiable factors: – Endemic

tuberculosis

– Poor socio-economic conditions

– HIV infection/ AIDS

– Drug addiction

– Alcoholism

• Non-ModifiableFactors:

– Race

– Gender

– Age

– Family History of

PulmonaryTuberculosis



Types of Pott’s Disease

1. Cervical

2. Thoracic

3. Lumbo-sacral



Anatomy and physiology

The vertebral column

provides structural

support for the trunk

and surrounds and

protects the spinalcord.

The vertebral column

also providesattachment points for

the muscles of the

back and ribs.



The vertebral disks

serve as shockabsorbers during

activities.

. They also allow thespine to flex and

extend.



Pathophysiology: Pulmonary tuberculosis

Spread of mycobacterium tuberculosis from other sites

Extrapulmonary tuberculosis results

Infection spreads from two adjacent vertebrae into the adjoining disc space

One vertebra is affected,

the disc is normal

2 vertebrae involved, the avascular

intervertebral disc cannot receive nutrientsand collapse

Disc tissue dies and broken down by

caseation

Vertebral narrow then collapse

POTT’S DISEASE

Spinal damage





Diagnostic test

•blood test

• tuberculin skin test

• bone scan

• bone biopsy

• spinal x-ray

• MRI



Complications • Vertebral collapse resulting in kyphosis.

• Spinal cord compression.

• Sinus formation. • Paraplegia (so called Pott's paraplegia).



Management:

Bed rest.

Immobilization of the spine is usually for 2 or

3 months.

Nutritious, high protein diet.

Drainage of abscess.

Surgical decompression.

Physiotherapy.



Medications:

Build up resistance of the

patient through:

V- Vitamins

I- IsoniazidP- Pyrazinamide

E- Ethambutol

R- RifampicinS- Streptomycin



Nursing management (post op)

• ensure spinal alignment by turning the pt as

a unit.• Application of brace when operative wound

has healed and dried up, before the pt gets

up.When applying the brace, the nurse:

applies the brace using the clothes and padding.

applies the brace while the patient is in sittingposition.



Patient should remember to attend check-ups atthe nearest…

Orthopedic centerT reatment should be taken in…

T imely manner

Sight any symptoms other than the usual andreport it to physician.

Prevention

As for all tuberculosis, BCG vaccination.

Improvement of socio-economic conditions.

Prevention of HIV and AIDS.

http://www.patient.co.uk/search.asp?searchterm=BACILLUS+CALMETTE+GUERIN++BCG++VACCINE

http://www.patient.co.uk/search.asp?searchterm=HUMAN+IMMUNODEFICIENCY+VIRUS

http://www.patient.co.uk/search.asp?searchterm=HUMAN+IMMUNODEFICIENCY+VIRUS

http://www.patient.co.uk/search.asp?searchterm=BACILLUS+CALMETTE+GUERIN++BCG++VACCINE



Nursing diagnosis:

• acute pain related to inflammatoryprocess

• impaired physical mobility

• Risk for infection

• Risk for impaired skin integrity

• Disturbed body images

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