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7/29/2019 Report Devera
http://slidepdf.com/reader/full/report-devera 1/17
POTT’S
DISEASE
7/29/2019 Report Devera
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Other name:
• Extrapulmonary Tuberculosis• Tuberculosis of the Spine
• Tuberculous Spondylitis
• Pott’s Caries
• David’s Disease
• Pott’s Curvature
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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.
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Causative organism:Mycobacterium
tuberculosis.
Spread: Haematogenous.
(by blood)
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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
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Types of Pott’s Disease
1. Cervical
2. Thoracic
3. Lumbo-sacral
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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.
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The vertebral disks
serve as shockabsorbers during
activities.
. They also allow thespine to flex and
extend.
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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
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7/29/2019 Report Devera
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Diagnostic test
•blood test
• tuberculin skin test
• bone scan
• bone biopsy
• spinal x-ray
• MRI
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Complications • Vertebral collapse resulting in kyphosis.
• Spinal cord compression.
• Sinus formation. • Paraplegia (so called Pott's paraplegia).
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Management:
Bed rest.
Immobilization of the spine is usually for 2 or
3 months.
Nutritious, high protein diet.
Drainage of abscess.
Surgical decompression.
Physiotherapy.
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Medications:
Build up resistance of the
patient through:
V- Vitamins
I- IsoniazidP- Pyrazinamide
E- Ethambutol
R- RifampicinS- Streptomycin
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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.
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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.
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Nursing diagnosis:
• acute pain related to inflammatoryprocess
• impaired physical mobility
• Risk for infection
• Risk for impaired skin integrity
• Disturbed body images